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Rev. 08.01.2020 1 of 25 Form No. SOSPPL Part Number Description UOM HCPC Retail EE1 SEAT-ECONO-EZE EA. E2609 $750 EE1-PIN SEAT INSERT - PIN LOCK ECONO-EZE EA. E2609 $920 EZ LITE1 SEAT w/2 EZ LITE CLAMPS, 2 - 30º CLAMPS/HINGE EA. E2609 $500 EZ LITE1-EXT. SEAT w/2 LONG EZ LITE CLAMPS, 2 - 30º CLAMPS/HINGE EA. E2609 $600 FASTCLAMP1 SEAT w/2 FASTCLAMPS EA. E2609 $650 GLIDE 1 SEAT w/2 GLIDELOCKS/HINGE EA. E2609 $600 101-1000 SEAT INSERT-SPECIFY SIZE EA. E2609 $250 101-1000A SEAT INSERT w/T-NUTS EA. E2609 $275 101-2000 SEAT-1" DRP. HK w/#436 - 30° CLAMPS EA. E2609 $715 101-4000 SEAT-ADJ. BRACKETS - J/L w/SPLIT COLLAR CLAMPS EA. E2609 $695 101-7500 SEAT-2 PR. EE HARDWARE EA. E2609 $850 101-7500-PIN SEAT-2 PR. PIN LOCK EE HARDWARE EA. E2609 $1,020 101-10000 SEAT-4 EZ LITE CLAMPS EA. E2609 $620 101-10000-EXT SEAT-4 LONG EZ LITE CLAMPS EA. E2609 $700 101-11000 SEAT-4 GLIDE LOCK CLAMPS EA. E2609 $695 EE2 BACK-ECONO-EZE EA. E2617 $750 EE2-PIN BACK INSERT-PIN LOCK ECONO EZE EA. E2617 $920 FASTCLAMP2 BACK w/2 FASTCLAMPS EA. E2617 $650 GLIDE2 BACK w/2 GLIDELOCKS w/2 L/J'S & HINGE EA. E2617 $600 102-1000 BACK INSERT w/LOOPS EA. E2617 $250 102-1000A BACK INSERT w/T-NUTS EA. E2617 $275 102-4000 BACK-ADJ. BRACKET J/L w/SPLIT COLLAR CLAMPS EA. E2617 $695 102-7500 BACK-2 PR. EE HARDWARE EA. E2617 $850 102-7500-PIN BACK-2 PR PIN LOCK EE HARDWARE EA. E2617 $1,020 Part Number Description UOM hccps Retail EE1-MICRO SEAT-ECONO-EZE -MICRO - ONLY AVAILABLE 14W SYSTEM & UNDER EA. E2609 $717 EASY CLAMP 1 SEAT - 2 EASY CLAMPS, 2 SPLIT COLLARS AND 2 30º CLAMPS EA. E2609 $544 101-3000 SEAT-1", 2", 3", DRP. HKS w/#403 SPLIT COLLAR CLAMPS EA. E2609 $497 101-5000 SEAT-4 L BRACKETS EA. E2609 $438 101-7000 SEAT-4 QUICK RELEASE EA. E2609 $668 101-12000 SEAT-2PR. EE MICRO HARDWARE - (14W SYSTEM AND UNDER ONLY) EA. E2609 $775 101-13000 SEAT w/2 GLIDE LOCK, 2 SPLIT COLLARS EA. E2609 $668 101-EASY CLAMP SEAT w/4 EASY CLAMPS AND 2 SPLIT COLLARS EA. E2609 $643 EB1-4-KIT SOLID SEAT 4 PT EB1-KIT EA. E2609 $1,104 EB1-EXT-KIT SEAT-2PT EZ LITE EXT EB1-KIT EA. E2609 $1,104 EB1-EZ-TDLR-KIT SEAT 4-PT TDLR EZ LITE / HINGE EA. E2609 $1,104 EB1-KIT SOLID SEAT 2 PT EB1-KIT EA. E2609 $1,104 EB1-KNOB-4 SUBSTITUTE 2-PT KNOB TO 4-PT KNOB EA. E2609 $367 EB1-KNOB-KIT SEAT-2PT KNOB HDWE EB1-KIT EA. E2609 $1,104 EB1-KNOB-PIN2 UPGRD 2-PT KNOB TO 2-PT PIN LK EA. E2609 $89 Seating & Positioning Price List Freedom Designs 2241 Madera Rd. Simi Valley, CA 93065 800.331.8551 || www.freedomdesigns.com || [email protected] 10% Increase Items

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  • Rev. 08.01.2020 1 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC RetailEE1 SEAT-ECONO-EZE EA. E2609 $750EE1-PIN SEAT INSERT - PIN LOCK ECONO-EZE EA. E2609 $920EZ LITE1 SEAT w/2 EZ LITE CLAMPS, 2 - 30º CLAMPS/HINGE EA. E2609 $500EZ LITE1-EXT. SEAT w/2 LONG EZ LITE CLAMPS, 2 - 30º CLAMPS/HINGE EA. E2609 $600FASTCLAMP1 SEAT w/2 FASTCLAMPS EA. E2609 $650GLIDE 1 SEAT w/2 GLIDELOCKS/HINGE EA. E2609 $600101-1000 SEAT INSERT-SPECIFY SIZE EA. E2609 $250101-1000A SEAT INSERT w/T-NUTS EA. E2609 $275101-2000 SEAT-1" DRP. HK w/#436 - 30° CLAMPS EA. E2609 $715101-4000 SEAT-ADJ. BRACKETS - J/L w/SPLIT COLLAR CLAMPS EA. E2609 $695101-7500 SEAT-2 PR. EE HARDWARE EA. E2609 $850101-7500-PIN SEAT-2 PR. PIN LOCK EE HARDWARE EA. E2609 $1,020101-10000 SEAT-4 EZ LITE CLAMPS EA. E2609 $620101-10000-EXT SEAT-4 LONG EZ LITE CLAMPS EA. E2609 $700101-11000 SEAT-4 GLIDE LOCK CLAMPS EA. E2609 $695EE2 BACK-ECONO-EZE EA. E2617 $750EE2-PIN BACK INSERT-PIN LOCK ECONO EZE EA. E2617 $920FASTCLAMP2 BACK w/2 FASTCLAMPS EA. E2617 $650GLIDE2 BACK w/2 GLIDELOCKS w/2 L/J'S & HINGE EA. E2617 $600102-1000 BACK INSERT w/LOOPS EA. E2617 $250102-1000A BACK INSERT w/T-NUTS EA. E2617 $275102-4000 BACK-ADJ. BRACKET J/L w/SPLIT COLLAR CLAMPS EA. E2617 $695102-7500 BACK-2 PR. EE HARDWARE EA. E2617 $850102-7500-PIN BACK-2 PR PIN LOCK EE HARDWARE EA. E2617 $1,020

    Part Number Description UOM hccps Retail

    EE1-MICRO SEAT-ECONO-EZE -MICRO - ONLY AVAILABLE 14W SYSTEM & UNDER EA. E2609 $717

    EASY CLAMP 1 SEAT - 2 EASY CLAMPS, 2 SPLIT COLLARS AND 2 30º CLAMPS EA. E2609 $544101-3000 SEAT-1", 2", 3", DRP. HKS w/#403 SPLIT COLLAR CLAMPS EA. E2609 $497101-5000 SEAT-4 L BRACKETS EA. E2609 $438101-7000 SEAT-4 QUICK RELEASE EA. E2609 $668

    101-12000 SEAT-2PR. EE MICRO HARDWARE - (14W SYSTEM AND UNDER ONLY) EA. E2609 $775

    101-13000 SEAT w/2 GLIDE LOCK, 2 SPLIT COLLARS EA. E2609 $668101-EASY CLAMP SEAT w/4 EASY CLAMPS AND 2 SPLIT COLLARS EA. E2609 $643EB1-4-KIT SOLID SEAT 4 PT EB1-KIT EA. E2609 $1,104EB1-EXT-KIT SEAT-2PT EZ LITE EXT EB1-KIT EA. E2609 $1,104EB1-EZ-TDLR-KIT SEAT 4-PT TDLR EZ LITE / HINGE EA. E2609 $1,104EB1-KIT SOLID SEAT 2 PT EB1-KIT EA. E2609 $1,104EB1-KNOB-4 SUBSTITUTE 2-PT KNOB TO 4-PT KNOB EA. E2609 $367EB1-KNOB-KIT SEAT-2PT KNOB HDWE EB1-KIT EA. E2609 $1,104EB1-KNOB-PIN2 UPGRD 2-PT KNOB TO 2-PT PIN LK EA. E2609 $89

    Seating & Positioning Price ListFreedom Designs

    2241 Madera Rd. Simi Valley, CA 93065800.331.8551 || www.freedomdesigns.com

    || [email protected]

    10% Increase Items

  • Rev. 08.01.2020 2 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC RetailEB1-KNOB-PIN4 UPGRD 2-PT KNOB TO 4-PT PIN LK EA. E2609 $462EB1-KNOB-TDLR-KIT SEAT 2-PT TDLR KNOB HDWE/HINGE EA. E2609 $1,104EB1-TDLR-KIT SEAT 2-PT TDLR FASTCLAMP/HINGE EA. E2609 $1,104EE2SL SPRING LOADED ECONO-EZE BACK EA. E2617 $875

    EE2-MICRO BACK-ECONO-EZE -MICRO - ONLY AVAILABLE 14W SYSTEM & UNDER EA. E2617 $717

    EZ LITE2 BACK w/2 SNAPLOCK CLAMPS/HINGE EA. E2617 $523EZ CONF2 EASY CONFORMING STD w/2L/J'S GLIDE LOCK & HINGE EA. E2617 $1,097EZ CONF-EXT2 EASY CONFORMING EXT w/2L/J'S GLIDE LOCK & HINGE EA. E2617 $1,149EZ CONF20 EASY W/CONFORMING BACK w/2 EASY CLAMPS EA. E2617 $1,191EZ CONF30 EASY CONFORMING EXT. BACK w/2 EASY CLAMPS EA. E2617 $1,184FASTCLAMP2-TDLR BACK 2 TODDLER FASTCLAMP EA. E2617 $492

    EASY CLAMP 2 BACK / 2EASY CLAMPS, 2SPLIT COLLARS AND 2 SEAT TO BACK HINGES EA. E2617 $609

    102-2000 BACK-1" DROP HOOKS EA. E2617 $426102-3000 BACK-1", 2", 3" DROP HOOKS EA. E2617 $497102-5000 BACK-4 L BRACKET EA. E2617 $438102-6000 BACK-4 SNAPLOCK EA. E2617 $523102-7000 BACK-4 QUICK RELEASE EA. E2617 $668102-12000 EASY CONFORMING STANDARD EA. E2617 $1,097102-13000 EASY CONFORMING EXTENDED EA. E2617 $1,097102-14000 BACK-4 GLIDELOCK CLAMPS w/J'S & L'S EA. E2617 $668102-14500 BACK-2 GLIDELOCK /2 408/ J&L'S EA. E2617 $668102-16000 BACK w/2 GLIDE LOCK, 2 SPLIT COLLARS EA. E2617 $668102-17000 EASY CONFORMING STD w/2 GLIDE LOCK, 2 SPLIT COLLARS EA. E2617 $1,097102-18000 EASY CONFORMING EXT w/2 GLIDE LOCK, 2 SPLIT COLLARS EA. E2617 $1,097102-20000 EASY CONFORMING BACK w/4 EASY CLAMPS EA. E2617 $1,274102-30000 EASY CONFORMING EXT. BACK w/4 EASY CLAMPS EA. E2617 $1,274102-35000 BACK w/4 FASTCLAMPS EA. E2617 $622102-EASY CLAMP BACK w/4 EASY CLAMPS OR 2 SPLIT COLLARS EA. E2617 $709EB2-4-KIT SOLID BACK 4 PT EB2-KIT EA. E2617 $1,166EB2-KIT SOLID BACK 2 PT EB2-KIT EA. E2617 $1,166EB2-KNOB-4 SUBSTITUTE 2-PT KNOB TO 4-PT KNOB EA. E2617 $430EB2-KNOB-KIT BACK-2PT KNOB HDWE EB2-KIT EA. E2617 $1,166EB2-KNOB-PIN2 UPGRD 2-PT KNOB TO 2-PT PIN LK EA. E2617 $93EB2-KNOB-PIN4 UPGRD 2-PT KNOB TO 4-PT PIN LK EA. E2617 $528EB2-KNOB-TDLR-KIT BACK 2-PT TDLR KNOB HDWE/HINGE EA. E2617 $1,166EB2-TDLR-KIT BACK 2-PT TDLR FASTCLAMP/HINGE EA. E2617 $1,166

    Part Number Description UOM hccps Retail

    MOD-1OVER18 SEAT OVER 18 X 18 EA. E2609 $70MOD-1OVER21 OVERSIZE SEAT OVER 21W OR 21D EA. E2609 $95MOD-1OVER24 SEAT OVER 24 X 24 EA. E2609 $118MOD-1A PHENOLIC BASE BASE SUBSTITUTION EA. E2609 $153MOD-1A1 1/4" BOLTERON BASE SUBSTITUTION EA. E2609 $101MOD-1A2 3/8" BOLTERON BASE SUBSTITUTION EA. K0108 $144MOD-1B CUT OUTS, FOAM/WOOD/FABRIC EA. E2609 $47MOD-1CL ASYMMETRICAL SEAT LONG LEFT EA. E2609 $92MOD-1CR ASYMMETRICAL SEAT LONG RIGHT EA. E2609 $92MOD-1E WEDGE CUT FOAM EA. E2609 $63

    5% Increase Items

  • Rev. 08.01.2020 3 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC RetailMOD-1G CUSHION SEPARATE FROM WOOD EA. E2609 $110MOD-1H TABS w/SNAPS (PAIR) PR. E2609 $28MOD-1I INCONTINENT LINER EA. E2609 $32MOD-1J LATERALLY SPLIT SEAT EA. E2609 $383MOD-1K ANTI THRUST SEAT FOAM EA. E2609 $221MOD-1L GRID SEAT FOAM - STANDARD 2 X 2 X 2 EA. E2609 $350MOD-1L1 GRID FIT KIT IN 3#, 4# OR 5# (EQUALS 9 PIECES) EA. E2609 $36

    MOD-1L2 GRID FIT KIT-T-FOAM IN SOFT, MEDIUM OR FIRM (EQUALS 9 PIECES) EA. E2609 $49

    MOD-1L2A GRID FIT KIT SUN IN SOFT, MEDIUM OR FIRM (EQUALS 9 PIECES) EA. E2609 $49MOD-1L3 GRID FIT KIT PUDGEE EA. E2609 $172MOD-1M TWO TONE UPHOLSTERY EA. E2609 $107

    MOD-1NMONOGRAM w/ SYSTEM - WHEN ORDERING SEAT AND BACK w/HARDWARE

    EA. $0

    MOD-1O NOTCH FOR BACK POSTS EA. $0MOD-1P HOOK & LOOP STRIPS PR. E2609 $49MOD-1Q T-NUTS SET E2609 $49MOD-1R PLANAR SEAT COVER ONLY w/ZIPPER EA. E2609 $101MOD-1RC CUSTOM SEAT COVER ONLY EA. QUOTEMOD-1R2 CONTOUR SEAT UPHOLSTERY ONLY w/ ZIPPER EA. E2609 $452MOD-1ROHO SEAT FREEDOM SEAT ROHO INSERT EA. E2609 $803MOD-1S FREE FORM SEAT EA. E2609 $272MOD-1S BAG FREE FORM BAG STYLE EA. E2609 $272MOD-1S1 LIQUID SUNMATE ONLY EA. E2609 $254MOD-1S1 BAG LIQUID SUNMATE ONLY - BAG STYLE EA. E2609 $254MOD-1S2 FREE FORM BLOCKER KIT PR. E2609 $298MOD-1S3 FREE FORM COVER ONLY EA. E2609 $212MOD-1S3A CUSTOM FREE FORM COVER ONLY EA. E2609 $376MOD-1S4 FREE FORM INTERNAL LATERALS PR. E2609 $197MOD-1T MONOGRAM NO SYSTEM ORDERED EA. E2609 $28MOD-1U REMOVABLE COVER GRID UPGRADE (WHEN ORDERING GRID SEAT) EA. E2609 $89MOD-1U1 STD. GRID COVER NO SEAT SET E2609 $268MOD-1U1C CUSTOM GRID COVER NO SEAT EA. QUOTEMOD-1V CONTOUR ABD/ANTI THRUST EA. E2609 $297MOD-1VA CONTOUR ABDUCTOR - NO ANTI THRUST EA. E2609 $297MOD-1W CONTOUR ADD/ANTI THRUST EA. E2609 $297MOD-1WA CONTOUR ADDUCTOR - NO ANTI THRUST EA. E2609 $297MOD-1X CHECKERBOARD CUT FOAM EA. E2609 $192MOD-1Y CONTOUR ABD/ADD/ANTI EA. E2609 $342MOD-1YA CONTOUR ABDUCTOR/ADDUCTOR N0 ANTI THRUST EA. E2609 $342MOD-1Z CUSHION BASE w/HOOK/LOOP EA. E2609 $237MOD-1BB I-MOD ON SEAT EA. E2609 $122MOD-1CC ZIPPER CLOSURE EA. $0MOD-1DD MODULAR CONTOUR CUSHION EA. E2609 $454MOD-1DD1 MODULAR CONTOUR FIT KIT/ADD/ABD EA. E2609 $39MOD-1DD2 MODULAR CONTOUR FIT KT - 10X10 EA. E2609 $39MOD-1DD3 MODULAR CONTOUR ANTI THRUST KIT SET E2609 $38MOD-1EE FOAM F/W, WOOD BETWEEN EA. E2609 $172MOD-1FF REMOVABLE INC. SLIP COVER EA. E2609 $214MOD-1GG TRACK MOUNT HARDWARE-LONG DUAL TRACKS PR. E2609 $56MOD-1HH FLIP & FOLD SEAT TO BACK HINGE BRACKET (substitute 430 or 430A) EA. $0

  • Rev. 08.01.2020 4 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC RetailMOD-1II 1/4" THICK APPLEWOOD EA. $0MOD-1KK OMIT WOOD EA. $0MOD-1UU-MILD CUT/CARVE/ CONTOUR- MILD EA. E2609 $484MOD-1UU-MODERATE CUT/CARVE/ CONTOUR- MODERATE EA. E2609 $484MOD-1UU-MAXIMUM CUT/CARVE/ CONTOUR- MAXIMUM EA. E2609 $484MOD-1WW LEAF FLARED SEAT EA. E2609 $428EB1CS1MLB 1/2" MAPLE LAMINATE BASE EA. $0EB1CS1WT BASE W/TNUTS, NO TRACKS INCLUD EA. $0STAN1 3# FOAM IN SEAT 1" E2609 $47HIGHD1 4# FOAM IN SEAT 1" E2609 $47TUF1 5# FOAM IN SEAT 1" E2609 $49DURA1 10# FOAM IN SEAT 1" E2609 $78TFOAM1 T-FOAM IN SEAT 1" E2609 $93PUDG1 PUDGEE IN SEAT 1" E2609 $219SUN1 SUNMATE IN SEAT 1" E2609 $86EVA1 EVA FOAM IN SEAT 1" E2609 $46FREE1 FREE FLOAT GEL IN SEAT (18 X 16 & UNDER) 1/2" E2609 $355FREE1 OVER FREE FLOAT GEL IN SEAT (18 X 16 & OVER) 1/2" E2609 $708WAFFLE1 WAFFLE FREE FLOAT GEL IN SEAT (18 X 16 & UNDER) 1/2" E2609 $282WAFFLE1 OVER WAFFLE FREE FLOAT GEL IN SEAT (18 X 16 & OVER) 1/2" E2609 $567ROHO1 ROHO ADAPTOR CUSHION INSERT - 1" CELLS - MAX SIZE 13" X 9" 1" E2609 $295MOD-2OVER18 OVERSIZE BACK OVER 18W OR 18H EA. E2617 $70MOD-2OVER21 OVERSIZE BACK OVER 21W OR 21H EA. E2617 $95MOD-2OVER24 OVERSIZE BACK OVER 24W OR 24H EA. E2617 $118MOD-2A 1/2" PHENOLIC BASE SUBSTITUTE EA. E2617 $209MOD-2A1 1/4" BOLTARON BASE SUBSTITUTE EA. E2617 $122MOD-2A2 3/8" BOLTARON BASE SUBSTITUTE EA. E2617 $173MOD-2B CUT OUTS WOOD/FOAM/FABRIC EA. E2617 $47MOD-2E WEDGE CUT FOAM EA. E2617 $66MOD-2G CUSHION SEPARATE FROM WOOD EA. E2617 $101MOD-2H I-MODIFICATION EA. E2617 $134MOD-2I CURVED BACK-WOOD EA. E2617 $141MOD-2IA CURVED BACK-FOAM EA. E2617 $121MOD-2J T-MODIFICATION EA. E2617 $134MOD-2K GRID BACK FOAM - STANDARD 2 X 2 X 2 EA. E2617 $350MOD-2K1 GRID FIT KIT IN 3#, 4# OR 5# (EQUALS 9 PIECES) EA. E2617 $36

    MOD-2K2GRID FIT KIT-T-FOAM IN SOFT, MEDIUM AND FIRM (EQUALS 9 PIECES)

    EA. E2617 $49

    MOD-2K2AGRID FIT KIT SUNMATE IN SOFT, MEDIUM OR FIRM (EQUALS 9 PIECES)

    EA. E2617 $49

    MOD-2K3 GRID FIT KIT-PUDGEE EA. E2617 $172MOD-2L BI-ANGULAR BACK EA. E2617 $318MOD-2LA BI-ANGULAR 1 PIECE COVER EA. E2617 $318MOD-2M TWO-TONE UPHOLSTERY EA. E2617 $107MOD-2N MONOGRAM w/SYSTEM EA. $0MOD-2O GROMMETS PR. E2617 $125MOD-2P HOOK & LOOP STRIPS PR. E2617 $49MOD-2Q T-NUTS SET E2617 $49MOD-2Q PLATEMATE HEADREST PLATEMATE EA. E2617 $49MOD-2R RE-COVER BACK EA. E2617 $101MOD-2R2 CONTOUR BACK UPHOLSTERY ONLY w/ZIPPER EA. E2617 $298

  • Rev. 08.01.2020 5 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC RetailMOD-2R2C CUSTOM CONTOUR UPHOLSTERY w/ZIPPER EA. QUOTEMOD-2S FREE FORM EA. E2617 $272MOD-2S BAG FREE FROM BAG STYLE EA, E2617 $272MOD-2S1 LIQUID SUNMATE ONLY EA. E2617 $254MOD-2S1 BAG LIQUID SUNMATE ONLY - BAG STYLE EA. E2618 $254MOD-2S2 FREE FORM BLOCKER KIT PR. E2617 $298MOD-2S3A FREE FORM COVER UPGRADE - NO CHEMICALS EA. E2617 $212MOD-2S3AC CUSTOM FREE FORM COVER ONLY - 4" STANDARD EA. QUOTEMOD-2S3B CUSTOM CONTOUR FREE FORM COVER - 4" STANDARD EA. E2617 $376MOD-2S4 FREE FORM INTERNAL LATERALS PR. E2617 $197MOD-2T MONOGRAM-NON SYSTEM EA. E2617 $28MOD-2U REMOVE COVER GRID UPGRADE EA. E2617 $89MOD-2UA STD. GRID COVER-NO BACK SET E2617 $268MOD-2UAC CUSTOM GRID COVER-NO BACK EA. QUOTEMOD-2V ROUND OFF:BOTTOM BACK EA. E2617 $86MOD-2W FOAM FULL WIDTH/WOOD BETWEEN EA. E2617 $190MOD-2X SCAPULAR CUT-OUTS PR. E2617 $146MOD-2Y CONTOUR BACK-FOAM EA. E2617 $377MOD-2Z ZIPPER CLOSURE EA. $0MOD-2BB MONOGRAM-DESIGN EA. QUOTEMOD-2DD BUILT-IN ADJ. LUMBAR SUPPORT EA. E2617 $314MOD-2EE CHECKERBOARD CUT FOAM EA. E2617 $192MOD-2FF MODULAR CONTOUR CUSHION EA. E2617 $475MOD-2GG ERGO-ADJ. BACK MODIFICATION EA. E2617 $443MOD-2HH ERGO-ADJ. NO BI-ANGULAR CUT EA. E2617 $318MOD-2II ERGO-WINGS W / HINGES ONLY EA. E2617 $383MOD-2JJ TRACK MOUNT HARDWARE-LONG DUAL TRACKS PR. E2617 $61MOD-2KK 1/4" THICK APPLEWOOD J- FOR 14" AND UNDER SYSTEMS ONLY EA. $0MOD-2LL EASY CONFORMING BACK COVER (102-12000) EA. E2617 $243MOD-2MM EASY CONFORMING BACK COVER - EXTENDED (102-13000) EA. E2617 $272MOD-2NN EASY CONFORMING BACK FLAP EA. E2617 $78MOD-2OO EASY CONFORMING BACK WING - INNER PR. E2617 $239MOD-2PP EASY CONFORMING BACK WING - OUTER PR. E2617 $239MOD-2QQ EASY CONFORMING BACK SPLIT OUTER WING PR. E2617 $243MOD-2ROHO BACK FREEDOM BACK ROHO INSERT EA. E2617 $803MOD-2RR ELASTIC BACKSLIP COVER - BACK EA. E2617 $270MOD-2SS EASY CONFORMING BACK - ALL ITEMS COVERED SEPARATELY EA. E2617 $203

    MOD-2UU EASY CONFORMING ADJUSTABLE SINGLE WING BACK MODIFICATION EA. E2617 $243

    MOD-2ECONO2 ECONO EZE UPGRADE, EASY CONFORMING BACK-2PT EA. E2617 $59MOD-2ECONO4 ECONO EZE UPGRADE, EASY CONFORMING BACK-4PT EA. E2617 $175EB2CB2MLB 1/2" MAPLE LAMINATE BASE EA. E2617 $0EB2CB2WT BASE W/TNUTS, NO TRACKS INCLUD EA. E2617 $0STAN2 3# FOAM IN BACK 1" E2617 $47HIGHD2 4# FOAM IN BACK 1" E2617 $47TUF2 5# FOAM IN BACK 1" E2617 $65DURA2 10# FOAM IN BACK 1" E2617 $114TFOAM2 T-FOAM IN BACK 1" E2617 $119PUDG2 PUDGEE IN BACK 1" E2617 $237SUN2 SUNMATE IN BACK 1" E2617 $110EVA2 EVA FOAM IN BACK 1" E2617 $46

  • Rev. 08.01.2020 6 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC RetailFREE2 FREE FLOAT GEL IN BACK (18 X 16 & UNDER) 1/2" E2617 $355FREE2 OVER FREE FLOAT GEL IN BACK (18 X 16 & OVER) 1/2" E2617 $708WAFFLE2 WAFFLE FREE FLOAT GEL IN BACK (18 X 16 & UNDER) 1/2" E2617 $282WAFFLE2 OVER WAFFLE FREE FLOAT GEL IN BACK (18 X 16 & OVER) 1/2" E2617 $567ROHO2 ROHO CELLS IN BACK 13 X 9 MAX - SPECIFY PLACEMENT 1" E2617 $128EE3A REMOVABLE MEDIAL PELVIC SPPORT EA. E0957/E1028 $249EE3A-TDLR REM MEDIAL PELVIC SPPORT TDLR EA. E0957/E1028 $249EE3B-2 FLIP DOWN MEDIAL PELVIC ASSY EA. E0957/E1028 $443EE3E ECONO-FLIP MEDIAL PELVIC ASSY EA. E0957/E1028 $443EE3M ANTI THRUST PELVIC HARNESS EA. K0108 $259EE3P HIDE AWAY FLIP DWN MEDIAL PELV EA. E0957/E1028 $443EE3S PUSH BUTTON FLIP DOWN ABDUCTOR EA. E0957/E1028 $422SFDI-3A2P-CUSTOM 2 POINT PADDED HIP BELT P/B CUSTOM EA. E0978 $102SFDI-3A2MP-XS 2 POINT PADDED HIP BELT 1" P/B X-SMALL EA. E0978 $81SFDI-3A2MP-S 2 POINT PADDED HIP BELT 1" P/B SMALL EA. E0978 $81SFDI-3A2P-S 2 POINT PADDED HIP BELT 1.5" P/B SMALL EA. E0978 $81SFDI-3A2P-M 2 POINT PADDED HIP BELT 1.5" P/B MEDIUM EA. E0978 $81SFDI-3A2P-L 2 POINT PADDED HIP BELT 1.5" P/B LARGE EA. E0978 $81SFDI-3A2LP-L 2 POINT PADDED HIP BELT 2" P/B LARGE EA. E0978 $81SFDI-3A2LP-XL 2 POINT PADDED HIP BELT 2" P/B X-LARGE EA. E0978 $81SFDI-3A2UP-CUSTOM 2 POINT HIP BELT P/B CUSTOM EA. E0978 $49SFDI-3A2UMP-XS 2 POINT HIP BELT 1" P/B X-SMALL EA. E0978 $39SFDI-3A2UMP-S 2 POINT HIP BELT 1" P/B SMALL EA. E0978 $39SFDI-3A2UP-S 2 POINT HIP BELT 1.5" P/B SMALL EA. E0978 $39SFDI-3A2UP-M 2 POINT HIP BELT 1.5" P/B MEDIUM EA. E0978 $39SFDI-3A2UP-L 2 POINT HIP BELT 1.5" P/B LARGE EA. E0978 $39SFDI-3A2ULP-L 2 POINT HIP BELT 2" P/B LARGE EA. E0978 $39SFDI-3A2ULP-XL 2 POINT HIP BELT 2" P/B X-LARGE EA. E0978 $39SFDI-3A2S-CUSTOM 2 POINT PADDED HIP BELT S/B CUSTOM EA. E0978 $81SFDI-3A2MS-XS 2 POINT PADDED HIP BELT 1" S/B X-SMALL EA. E0978 $59SFDI-3A2MS-S 2 POINT PADDED HIP BELT 1" S/B SMALL EA. E0978 $59SFDI-3A2S-S 2 POINT PADDED HIP BELT 1.5" S/B SMALL EA. E0978 $59SFDI-3A2S-M 2 POINT PADDED HIP BELT 1.5" S/B MEDIUM EA. E0978 $59SFDI-3A2S-L 2 POINT PADDED HIP BELT 1.5" S/B LARGE EA. E0978 $59SFDI-3A2LS-L 2 POINT PADDED HIP BELT 2" S/B LARGE EA. E0978 $59SFDI-3A2LS-XL 2 POINT PADDED HIP BELT 2" S/B X-LARGE EA. E0978 $59SFDI-3A2US-CUSTOM 2 POINT HIP BELT S/B CUSTOM EA. E0978 $44SFDI-3A2UMS-XS 2 POINT HIP BELT 1" S/B X-SMALL EA. E0978 $34SFDI-3A2UMS-S 2 POINT HIP BELT 1" S/B SMALL EA. E0978 $34SFDI-3A2US-S 2 POINT HIP BELT 1.5" S/B SMALL EA. E0978 $34SFDI-3A2US-M 2 POINT HIP BELT 1.5" S/B MEDIUM EA. E0978 $34SFDI-3A2US-L 2 POINT HIP BELT 1.5" S/B LARGE EA. E0978 $34SFDI-3A2ULS-L 2 POINT HIP BELT 2" S/B LARGE EA. E0978 $34SFDI-3A2ULS-XL 2 POINT HIP BELT 2" S/B X-LARGE EA. E0978 $34SFDI-3HBP-CUSTOM-2 SELECT HIP BELT PADS ONLY CUSTOM PR K0108 $63SFDI-3HBP-XS-2 SELECT HIP BELT PADS ONLY X-SMALL PR K0108 $42SFDI-3HBP-S-2 SELECT HIP BELT PADS ONLY SMALL PR K0108 $42SFDI-3HBP-M-2 SELECT HIP BELT PADS ONLY MEDIUM PR K0108 $42SFDI-3HBP-L-2 SELECT HIP BELT PADS ONLY LARGE PR K0108 $42SFDI-3HBP-XL-2 SELECT HIP BELT PADS ONLY X-LARGE PR K0108 $42SFDI-3A4P-CUSTOM 4 PT HIP BLT PADDED P/B CUSTOM EA. E0978 $204

  • Rev. 08.01.2020 7 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC RetailSFDI-3A4MP-XS 4 PT HIP BLT PADDED 1" P/B X-SMALL EA. E0978 $176SFDI-3A4MP-S 4 PT HIP BLT PADDED 1" P/B SMALL EA. E0978 $176SFDI-3A4P-S 4 PT HIP BLT PADDED 1.5" P/B SMALL EA. E0978 $176SFDI-3A4P-M 4 PT HIP BLT PADDED 1.5" P/B MEDIUM EA. E0978 $176SFDI-3A4P-L 4 PT HIP BLT PADDED 1.5" P/B LARGE EA. E0978 $176SFDI-3A4P-XL 4 PT HIP BLT PDDED 1.5" P/B X-LARGE EA. E0978 $176SFDI-3A4LP-XL 4 PT HIP BLT PADDED 2" P/B X-LARGE EA. E0978 $176SFDI-3A4S-CUSTOM 4 PT HIP BLT PADDED 1.5" S/R CUSTOM EA. E0978 $204SFDI-3A4MS-XS 4 PT HIP BLT PADDED 1" S/R X-SMALL EA. E0978 $176SFDI-3A4MS-S 4 PT HIP BLT PADDED 1" S/R SMALL EA. E0978 $176SFDI-3A4S-S 4 PT HIP BLT PADDED 1.5" S/R SMALL EA. E0978 $176SFDI-3A4S-M 4 PT HIP BLT PADDED 1.5" S/R MEDIUM EA. E0978 $176SFDI-3A4S-L 4 PT HIP BLT PADDED 1.5" S/R LARGE EA. E0978 $176SFDI-3A4S-XL 4 PT HIP BLT PADDED 1.5" S/R X-LARGE EA. E0978 $176SFDI-3A4LS-XL 4 PT HIP BLT PADDED 2" S/R X-LARGE EA. E0978 $176MOD-3D SEALED INCONTINENT LINER EA. E0956/E1028 $22MOD-3E ABDUCTOR PAD ONLY EA. E0956/E1028 $179MOD-3F EXTENSION BRACKET EA. E0956/E1028 $29MOD-3I MEDIAL THIGH SUPPORT PAD - COVER ONLY EA. E0956/E1028 $63MOD-3J EXTENSION BRACKET FOR (EE3P HIDE AWAY ABDUCTOR) EA. E0956/E1028 $29MOD-3L REINFORCEMENT OF ANTI-THRUST PELVIC HARNESS (EE3M) EA. E0956/E1028 $97MOD-3M FABRIC BOOT FOR ABDUCTOR HARDWARE EA. E0956/E1028 $62MOD-3N HORIZONTAL DOUBLE TRACK FOR EE3 EA. $0MOD-3O SLIP COVER - ABDUCTOR EA. K0108 $189STAN4 3# FOAM IN ABDUCTOR PAD 1" K0108 $30HIGHD4 4# FOAM IN ABDUCTOR PAD 1" K0108 $27TUF4 5# FOAM IN ABDUCTOR PAD 1" K0108 $35DURA4 10# FOAM IN ABDUCTOR PAD 1" K0108 $56TFOAM4 T-FOAM IN ABDUCTOR PAD 1" K0108 $34PUDG4 PUDGEE IN ABDUCTOR PAD 1" K0108 $131SUN4 SUNMATE IN ABDUCTOR PAD 1" K0108 $42EVA4 EVA FOAM IN ABDUCTOR PAD 1" K0108 $9FREE4 FREE FLOAT GEL IN ABDUCTOR 1/2" K0108 $82WAFFLE4 WAFFLE FREE FLOAT GEL IN ABDUCTOR 1/2" K0108 $114ROHO4 ROHO ADAPTER CUSHION INSERT IN ABDUCTOR 1" K0108 $128EE4A-STD LATERALS-L BRACKET-STD 4# PR. E0956 $249EE4A-SUN LATERALS-L BRACKET-MED SUN PR. E0956 $249EE4A-T-FOAM LATERALS-L BRACKET-MED T-FOAM PR. E0956 $249EE4A-THIN LATERALS-L BRACKET-THIN PR. E0956 $249EE4B-STD LATERALS-OFFSET-STD 4# PR. E0956 $249EE4B-SUN LATERALS-OFFSET-MED SUN PR. E0956 $249EE4B-T-FOAM LATERALS-OFFSET-MED T-FOAM PR. E0956 $249EE4B-THIN LATERALS-L BRACKET-THIN PR. E0956 $249EE4C-STD LATERALS-QUICK RELEASE-STD 4# PR. E0956/E1028 $498EE4C-SUN LATERALS-QUICK RELEASE-MED SUN PR. E0956/E1028 $498EE4C-T-FOAM LATERALS-QUICK RELEASE-MED T-FOAM PR. E0956/E1028 $498EE4C-THIN LATERALS-QUICK RELEASE-THIN PR. E0956/E1028 $498

    EE4D-STDHANGER MOUNTED ADDUCTOR-STD 4" FOAM-OVAL(1" DIA. HANGER TUBE ONLY)

    PR. E0956 $545

    EE4D-SUNHANGER MOUNTED ADDUCTOR-SUNMATE FOAM -OVAL(1" DIA. HANGER TUBE ONLY)

    PR. E0956 $545

  • Rev. 08.01.2020 8 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC Retail

    EE4D-T-FOAMHANGER MOUNTED ADDUCTOR-T-FOAM -OVAL(1" DIA. HANGER TUBE ONLY)

    PR. E0956 $545

    EE4E-STD LATERAL PELVIC FIX/ARM HEIGHT ADJ 4# PR. E0956 $355EE4E-SUN LATERAL PELVIC FIX/ARM HEIGHT ADJ.-MED SUNMATE PR. E0956 $355EE4E-T-FOAM LATERAL PELVIC FIX/ARM HEIGHT ADJ.-MED T-FOAM PR. E0956 $355EE4E-THIN LATERAL PELVIC FIX/ARM HEIGHT ADJ.-THIN PR. E0956 $355EE4G-STD LATERALS QR/ARMS HEIGHT ADJ.-STD 4# PR. E0956/E1028 $520EE4G-SUN LATERALS QR/ARMS HEIGHT ADJ.-MED SUN PR. E0956/E1028 $520EE4G-T-FOAM LATERALS QR/ARMS HEIGHT ADJ.-MED T-FOAM PR. E0956/E1028 $520EE4G-THIN LATERALS QR/ARMS HEIGHT ADJ.-THIN PR. E0956/E1028 $520EE4H-STD HIP-QUICK RELEASE/ARM-QUICK RELEASE PR. E0956/E1028 $590EE4H-SUN LATERALS QR/ARMS QR MED SUN PR. E0956/E1028 $590EE4H-T-FOAM LATERALS QR/ARMS QR MED T-FOAM PR. E0956/E1028 $590EE4H-THIN LATERALS QR/ARMS QR .25" 10# ABS PR. E0956/E1028 $590EE4I TRACKS FOR HIP/THIGH SUPPORT PR. K0108 $50EE4I-DUAL DUAL TRACKS FOR HIP/THIGH SUPPORT PR. K0108 $57MOD-4A CUSTOM CONTOUR PR. E0956 $95MOD-4B-STD LATERAL PADS ONLY-STD 4# PR. E0956 $189MOD-4B-SUN LATERAL PADS ONLY-MED SUN PR. E0956 $189MOD-4B-T-FOAM LATERAL PADS ONLY-MED T-FOAM PR. E0956 $189MOD-4B-THIN LATERAL PADS ONLY-THIN PR. E0956 $189MOD-4C RE-COVER LATERAL PADS PR. K0108 $88MOD-4D EXTENSION BRACKET EA. K0108 $44MOD-4G HIP/THIGH HARDWARE BOOTS PR. K0108 $57MOD-4I SLIP COVER - HIP GUIDES PR. K0108 $185MOD-4J-STD EE4D PADS ONLY PR. E0956 $189STAN3 3# FOAM IN LATERAL TRUNK & HIP PADS 1" K0108 $14HIGHD3 4# FOAM IN LATERAL TRUNK & HIP PADS 1" K0108 $19TUF3 5# FOAM IN LATERAL TRUNK & HIP PADS 1" K0108 $27DURA3 10# FOAM IN LATERAL TRUNK & HIP PADS 1" K0108 $34TFOAM3 T-FOAM IN LATERAL TRUNK & HIP PADS 1" K0108 $22PUDG3 PUDGEE IN LATERAL TRUNK & HIP PADS 1" K0108 $91SUN3 SUNMATE IN LATERAL TRUNK & HIP PADS 1" K0108 $34EVA3 EVA FOAM IN LATERAL TRUNK/HIP PADS 1" K0108 $7FREE3 FREE FLOAT GEL IN LATERAL TRUNK/HIP 1/2" K0108 $82WAFFLE3 WAFFLE FREE FLOAT GEL IN TRUNK./HIP PADS 1/2" K0108 $114ROHO3 ROHO ADAPTER CUSHION INSERT - LATERAL TRUNK PADS PR. K0108 $128ROHO3HG ROHO ADAPTER CUSHION INSERT - LATERAL HIP PADS PR. K0108 $128EE5A-STD THORACIC SUPPORT-L BRACKET-STD 4# PR. E0956 $249EE5A-SUN THORACIC SUPPORT-L BRACKET-MED SUN PR. E0956 $249EE5A-T-FOAM THORACIC SUPPORT-L BRACKET-MED T-FOAM PR. E0956 $249EE5A-THIN THORACIC SUPPORT-L BRACKET-THIN PR. E0956 $249EE5A-TR-STD THORACIC SUPPORT-L BRACKET-STD 4# w/TRACKS PR. E0956 $299EE5A-TR-SUN THORACIC SUPPORT-L BRACKET-MED SUN w/TRACKS PR. E0956 $299EE5A-TR-T-FOAM THORACIC SUPPORT-L BRACKET-MED T-FOAM w/TRACKS PR. E0956 $299EE5A-TR-THIN THORACIC SUPPORT-L BRACKET-THIN w/TRACKS PR. E0956 $299EE5B-STD THORACIC SUPPORT-OFFSET-STD 4# PR. E0956 $249EE5B-SUN THORACIC SUPPORT-OFFSET-MED SUN PR. E0956 $249EE5B-T-FOAM THORACIC SUPPORT-OFFSET-MED T-FOAM PR. E0956 $249EE5B-THIN THORACIC SUPPORT-OFFSET-STD-THIN PR. E0956 $249EE5B-TR-STD THORACIC SUPPORT-OFFSET-STD 4# w/TRACKS PR. E0956 $299

  • Rev. 08.01.2020 9 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC RetailEE5B-TR-SUN THORACIC SUPPORT-OFFSET-MED SUN w/TRACKS PR. E0956 $299EE5B-TR-T-FOAM THORACIC SUPPORT-OFFSET-MED T-FOAM w/TRACKS PR. E0956 $299EE5B-TR-THIN THORACIC SUPPORT-OFFSET-THIN w/TRACKS PR. E0956 $299EE5E-STD S/A THORACIC SUPPORT-STD 4# PR. E0956/E1028 $498EE5E-SUN S/A THORACIC SUPPORT-MED SUN PR. E0956/E1028 $498EE5E-T-FOAM S/A THORACIC SUPPORT-MED T-FOAM PR. E0956/E1028 $498EE5E-THIN S/A THORACIC SUPPORT-THIN PR. E0956/E1028 $498EE5E-TR-STD S/A THORACIC SUPPORT-STD 4# w/TRACKS PR. E0956/E1028 $548EE5E-TR-SUN S/A THORACIC SUPPORT-MED SUN w/TRACKS PR. E0956/E1028 $548EE5E-TR-T-FOAM S/A THORACIC SUPPORT-MED T-FOAM w/TRACKS PR. E0956/E1028 $548EE5E-TR-THIN S/A THORACIC SUPPORT-STD-THIN w/TRACKS PR. E0956/E1028 $548EE5G-STD QUICK REL. THORACIC SUPPORT-STD 4# PR. E0956/E1028 $498EE5G-SUN QUICK REL. THORACIC SUPPORT-MED SUN PR. E0956/E1028 $498EE5G-T-FOAM QUICK REL. THORACIC SUPPORT-MED T-FOAM PR. E0956/E1028 $498EE5G-THIN QUICK REL. THORACIC SUPPORT-THIN PR. E0956/E1028 $498EE5G-TR-STD QUICK REL. THORACIC SUPPORT-STD 4# w/TRACKS PR. E0956/E1028 $548EE5G-TR-SUN QUICK REL. THORACIC SUPPORT-MED SUN w/TRACKS PR. E0956/E1028 $548EE5G-TR-T-FOAM QUICK REL. THORACIC SUPPORT-MED T-FOAM w/TRACKS PR. E0956/E1028 $548EE5G-TR-THIN QUICK REL. THORACIC SUPPORT-STD-THIN w/TRACKS PR. E0956/E1028 $548EE5I TRACKS-THORACIC SUPPORT PR. K0108 $55EE5J-STD FIXED THORACIC-SUMMER WINTER-STD 4# PR. E0956/E1028 $422EE5J-SUN FIXED THORACIC-SUMMER WINTER-MED SUN PR. E0956/E1028 $422EE5J-T-FOAM FIXED THORACIC-SUMMER WINTER-MED T-FOAM PR. E0956/E1028 $422EE5J-THIN FIXED THORACIC-SUMMER WINTER-THIN PR. E0956/E1028 $422EE5J-TR-STD FIXED THORACIC-SUMMER WINTER-STD 4# w/TRACKS PR. E0956/E1028 $590EE5J-TR-SUN FIXED THORACIC-SUMMER WINTER-MED SUN w/TRACKS PR. E0956/E1028 $590EE5J-TR-T-FOAM FIXED THORACIC-SUMMER WINTER-MED T-FOAM w/TRACKS PR. E0956/E1028 $590EE5J-TR-THIN FIXED THORACIC-SUMMER WINTER-THIN w/TRACKS PR. E0956/E1028 $590EE5K-STD SWING/AWAY w/SUMMER WINTER-STD 4# PR. E0956/E1028 $665EE5K-SUN SWING/AWAY w/SUMMER WINTER-MED SUN PR. E0956/E1028 $665EE5K-T-FOAM SWING/AWAY w/SUMMER WINTER-MED T-FOAM PR. E0956/E1028 $665EE5K-THIN SWING/AWAY w/SUMMER WINTER-THIN PR. E0956/E1028 $665EE5K-TR-STD SWING/AWAY w/SUMMER WINTER-STD 4# w/TRACKS PR. E0956/E1028 $715EE5K-TR-SUN SWING/AWAY w/SUMMER WINTER-MED SUN w/TRACKS PR. E0956/E1028 $715EE5K-TR-T-FOAM SWING/AWAY w/SUMMER WINTER-MED T-FOAM w/TRACKS PR. E0956/E1028 $715EE5K-TR-THIN SWING/AWAY w/SUMMER WINTER-THIN w/TRACKS PR. E0956/E1028 $715EE5P-STD S/A LEVER RELEASE THORACIC-STD 4# PR. E0956/E1028 $559EE5P-SUN S/A LEVER RELEASE THORACIC-MED SUN PR. E0956/E1028 $559EE5P-T-FOAM S/A LEVER RELEASE THORACIC-MED T-FOAM PR. E0956/E1028 $559EE5P-THIN S/A LEVER RELEASE THORACIC-THIN PR. E0956/E1028 $559EE5P-TR-STD S/A LEVER RELEASE THORACIC-STD 4# w/TRACKS PR. E0956/E1028 $609EE5P-TR-SUN S/A LEVER RELEASE THORACIC-MED SUN w/TRACKS PR. E0956/E1028 $609EE5P-TR-T-FOAM S/A LEVER RELEASE THORACIC-MED T-FOAM w/TRACKS PR. E0956/E1028 $609EE5P-TR-THIN S/A LEVER RELEASE THORACIC-THIN w/TRACKS PR. E0956/E1028 $609EE5Q-STD S/A LEVER RELEASE SUM/WINTER-STD 4# PR. E0956/E1028 $702EE5Q-SUN S/A LEVER RELEASE SUM/WINTER-MED SUN PR. E0956/E1028 $702EE5Q-T-FOAM S/A LEVER RELEASE SUM/WINTER-MED T-FOAM PR. E0956/E1028 $702EE5Q-THIN S/A LEVER RELEASE SUM/WINTER-THIN PR. E0956/E1028 $702EE5Q-TR-STD S/A LEVER RELEASE SUM/WINTER-STD 4# w/TRACKS PR. E0956/E1028 $754EE5Q-TR-SUN S/A LEVER RELEASE SUM/WINTER-MED SUN w/TRACKS PR. E0956/E1028 $754EE5Q-TR-T-FOAM S/A LEVER RELEASE SUM/WINTER-MED T-FOAM w/TRACKS PR. E0956/E1028 $754

  • Rev. 08.01.2020 10 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC RetailEE5Q-TR-THIN S/A LEVER RELEASE SUM/WINTER-THIN w/TRACKS PR. E0956/E1028 $754EE5W-STD PUSH BUTTON S/A THORACIC SUPPORT STD 4# PR. E0956/E1028 $498EE5W-SUN PUSH BUTTON S/A THORACIC SUPPORT-MED SUN PR. E0956/E1028 $498EE5W-T-FOAM PUSH BUTTON S/A THORACIC SUPPORT-MED T-FOAM PR. E0956/E1028 $498EE5W-THIN PUSH BUTTON S/A THORACIC SUPPORT-THIN PR. E0956/E1028 $498EE5W-TR-STD PUSH BUTTON S/A THORACIC SUPPORT-STD 4# w/TRACKS PR. E0956/E1028 $548EE5W-TR-SUN PUSH BUTTON S/A THORACIC SUPPORT-MED SUN w/TRACKS PR. E0956/E1028 $548EE5W-TR-T-FOAM PUSH BUTTON S/A THORACIC SUPPORT-MED T-FOAM w/TRACKS PR. E0956/E1028 $548EE5W-TR-THIN PUSH BUTTON S/A THORACIC SUPPORT-STD-THIN w/TRACKS PR. E0956/E1028 $548EE5X-STD PUSH BUTTON S/A - S/W THORACIC SUPPORT STD 4# PR. E0956/E1028 $498EE5X-SUN PUSH BUTTON S/A - S/W THORACIC SUPPORT-MED SUN PR. E0956/E1028 $498EE5X-T-FOAM PUSH BUTTON S/A - S/W THORACIC SUPPORT-MED T-FOAM PR. E0956/E1028 $498EE5X-THIN PUSH BUTTON S/A - S/W THORACIC SUPPORT-THIN PR. E0956/E1028 $498EE5X-TR-STD PUSH BUTTON S/A - S/W THORACIC SUPPORT-STD 4# w/TRACKS PR. E0956/E1028 $548EE5X-TR-SUN PUSH BUTTON S/A - S/W THORACIC SUPPORT-MED SUN w/TRACKS PR. E0956/E1028 $548

    EE5X-TR-T-FOAMPUSH BUTTON S/A - S/W THORACIC SUPPORT-MED T-FOAM w/TRACKS

    PR. E0956/E1028 $548

    EE5X-TR-THIN PUSH BUTTON S/A - S/W THORACIC SUPPORT-STD-THIN w/TRACKS PR. E0956/E1028 $548105-6000 LUMBAR SUPPORT EA. E0956/E1028 $108MOD-5B BREAST RELIEF CUT-OUTS PR. K0108 $68MOD-5E ROLL-OVER PADS PR. K0108 $51MOD-5F PROTECTIVE BOOTS PR. E0956 $54MOD-5G-STD THORACIC SUPPORT PADS ONLY-STD 4# PR. E0956 $189MOD-5G-SUN THORACIC SUPPORT PADS ONLY-MED SUN PR. E0956 $189MOD-5G-T-FOAM THORACIC SUPPORT PADS ONLY-MED T-FOAM PR. E0956 $189MOD-5G-THIN THORACIC SUPPORT PADS ONLY-THIN PR. E0956 $189MOD-5J EXTENSION BRACKETS EA. K0108 $44MOD-5K THIN PROFILE PADS EA. $0MOD-5L RE-COVER THORACIC SUPPORT PAD PR. K0108 $84MOD-5M CONTOUR FIT LATERAL PADS PR. K0108 $65MOD-5N SLIP COVER - TRUNK SUPPORTS PR. K0108 $195STAN3 3# FOAM IN LATERAL TRUNK & HIP PADS 1" K0108 $14HIGHD3 4# FOAM IN LATERAL TRUNK & HIP PADS 1" K0108 $19TUF3 5# FOAM IN LATERAL TRUNK & HIP PADS 1" K0108 $27DURA3 10# FOAM IN LATERAL TRUNK & HIP PADS 1" K0108 $34TFOAM3 T-FOAM IN LATERAL TRUNK & HIP PADS 1" K0108 $22PUDG3 PUDGEE IN LATERAL TRUNK & HIP PADS 1" K0108 $91SUN3 SUNMATE IN LATERAL TRUNK & HIP PADS 1" K0108 $34EVA3 EVA FOAM IN LATERAL TRUNK/HIP PADS 1" K0108 $7FREE3 FREE FLOAT GEL IN LATERAL TRUNK/HIP 1/2" K0108 $82WAFFLE3 WAFFLE FREE FLOAT GEL IN TRUNK/HIP 1/2" K0108 $114ROHO3 ROHO ADAPTER CUSHION INSERT - LATERAL TRUNK PADS PR. K0108 $128ROHO3HG ROHO ADAPTER CUSHION INSERT - LATERAL HIP PADS PR. K0108 $128EE6C BUTTERFLY CHEST VEST EA. E0960 $251EE6L ANTERIOR/POSTER PULL STATIC EA. E0960 $138EE6P BUTTERFLY w/SWIVELS EA. E0960 $251EE6Q CLEAR CHEST VEST EA. E0960 $251EE6R THORACIC SUPPORT VEST EA. E0960 $172EE6S X-CHEST VEST EA. E0960 $172EE6U TAPERED DYNAMIC VEST EA. E0960 $172EE6V FREEDOM FORM VEST EA. E0960 $172

  • Rev. 08.01.2020 11 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC RetailEE6X TAPERED A.P. HARNESS EA. E0960 $173SFDI-6CS1B-L CHEST STRAP 1 PC BUCKLE LRG EA. E0960 $128SFDI-6CS1B-M CHEST STRAP 1 PC BUCKLE MED EA. E0960 $128SFDI-6CS1B-S CHEST STRAP 1 PC BUCKLE SM EA. E0960 $128SFDI-6CS1B-XS CHEST STRAP 1 PC BUCKLE X-SM EA. E0960 $128SFDI-6CS1B-XL CHEST STRAP 1 PC BUCKLE X-LARGE EA. E0960 $139SFDI-6CS2V-L CHEST STRAP 2 PC VELCRO LARGE EA. E0960 $128SFDI-6CS2V-M CHEST STRAP 2 PC VELCRO MED EA. E0960 $128SFDI-6CS2V-S CHEST STRAP 2 PC VELCRO SMALL EA. E0960 $128SFDI-6CUSTOM SELECT ANT TRUNK SPRT CUSTOM EA. E0960 $204SFDI-6NNZ-1-L ANT TRUNK SPRT NRW D-R LARGE EA. E0960 $145SFDI-6NNZ-1-M ANT TRUNK SPRT NRW D-R MED EA. E0960 $140SFDI-6NNZ-1-S ANT TRUNK SPRT NRW D-R SMALL EA. E0960 $140SFDI-6NNZ-1-XL ANT TRUNK SPRT NRW D-R XL EA. E0960 $150SFDI-6NNZ-1-XS ANT TRUNK SPRT NRW D-R X-SMALL EA. E0960 $140SFDI-6NNZ-L ANT TRUNK SPRT NRW L EA. E0960 $145SFDI-6NNZ-M ANT TRUNK SPRT NRW M EA. E0960 $140SFDI-6NNZ-S ANT TRUNK SPRT NRW SMALL EA. E0960 $140SFDI-6NNZ-XL ANT TRUNK SPRT NRW X-LARGE EA. E0960 $150SFDI-6NNZ-XS ANT TRUNK SPRT NRW X-SMALL EA. E0960 $140SFDI-6NZ-1-L ANT TRNK SPRT NRW ZPR D-R LARGE EA. E0960 $150SFDI-6NZ-1-M ANT TRNK SPRT NRW ZPR D-R MED EA. E0960 $140SFDI-6NZ-L ANT TRUNK SPRT NRW ZPR LARGE EA. E0960 $150SFDI-6NZ-M ANT TRUNK SPRT NRW ZPR MED EA. E0960 $145SFDI-6NZ-XL ANT TRUNK SPRT NRW ZPR X-LARGE EA. E0960 $155SFDI-6SNZ-1-L ANT TRUNK SPRT STD D-R LARGE EA. E0960 $150SFDI-6SNZ-1-M ANT TRUNK SPRT STD D-R MED EA. E0960 $145SFDI-6SNZ-1-S ANT TRUNK SPRT STD D-R SM EA. E0960 $145SFDI-6SNZ-1-XL ANT TRUNK SPRT STD D-R X-LARGE EA. E0960 $150SFDI-6SNZ-L ANT TRUNK SPRT STD LARGE EA. E0960 $150SFDI-6SNZ-M ANT TRUNK SPRT STD MED EA. E0960 $140SFDI-6SNZ-S ANT TRUNK SPRT STD SM EA. E0960 $140SFDI-6SNZ-XL ANT TRUNK SPRT STD X-LARGE EA. E0960 $150SFDI-6SZ-1-L ANT TRUNK SPRT STD ZPR D-R LARGE EA. E0960 $150SFDI-6SZ-1-M ANT TRUNK SPRT STD ZPR D-R MED EA. E0960 $145SFDI-6SZ-1-S ANT TRUNK SPRT STD ZPR D-R SM EA. E0960 $145SFDI-6SZ-1-XL ANT TRUNK SPRT ST ZPR D-R X-LARGE EA. E0960 $155SFDI-6SZ-L ANT TRUNK SPRT STD ZPR LARGE EA. E0960 $150SFDI-6SZ-M ANT TRUNK SPRT STD ZPR MED EA. E0960 $145SFDI-6SZ-S ANT TRUNK SPRT STD ZPR SM EA. E0960 $145SFDI-6SZ-XL ANT TRUNK SPRT ST ZPR X-LARGE EA. E0960 $155MOD-6A ADJUSTABLE STRAP RISERS-STRAIGHT PR. K0108 $56MOD-6A-1 ADJUSTABLE STRAP RISERS-STRAIGHT - 1" PR. K0108 $56MOD-6B ADJUSTABLE STRAP RISERS-BEND PR. K0108 $56MOD-6B-1 ADJUSTABLE STRAP RISERS-BEND - 1" PR. K0108 $56MOD-6D G-TUBE CUT-OUT EA. K0108 $25MOD-6E REINFORCE ANY CHEST VEST OR HARNESS EA. K0108 $927750-STD SLIGHTLY CURVED HEADREST PAD-STD FOAM EA. E0955 $1077750-SUN SLIGHTLY CURVED HEADREST PAD-SUNMATE EA. E0955 $1077750-T-FOAM SLIGHTLY CURVED HEADREST PAD-TFOAM EA. E0955 $1077750-BELL SLIGHTLY CURVED, BELL-SHAPPED HEADREST PAD EA. E0955 $259

  • Rev. 08.01.2020 12 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC Retail7753-STD 3-PIECE HINGE-ADJ HEADREST PAD-STD FOAM EA. E0955 $3307753-SUN 3-PIECE HINGE-ADJ HEADREST PAD-SUNMATE EA. E0955 $3307753-T-FOAM 3-PIECE HINGE-ADJ HEADREST PAD-TFOAM EA. E0955 $3307755-STD HEADREST EXTENSION PAD, FLAT-STD FOAM EA. E0955 $1447755-SUN HEADREST EXTENSION PAD, FLAT-SUNMATE EA. E0955 $1447755-T-FOAM HEADREST EXTENSION PAD, FLAT-TFOAM EA. E0955 $1447756 CHUBBIE CURVED HEADREST PAD EA. E0955 $1977756-ADJ ADJUSTA-CHUBBIE 3-PIECE HINGED CURVED HEADREST PAD EA. E0955 $3757756-BELL CHUBBIE CURVED, BELL-SHAPPED HEADREST PAD EA. E0955 $2357757 LOW PROFILE OCCIPITAL SUPPORT HEADREST PAD EA. E0955 $1567758 3-PIECE HINGE-ADJ HEADREST PAD W/ EAR RELIEF CUT EA. E0955 $3317760 SKINNY CURVED HEADREST PAD EA. E0955 $1977700 KNOB STYLE HEIGHT & DEPTH ADJ, REMOVABLE L-BRACKET MOUNT EA. E1028 $1517701 PULL-PIN HEIGHT ADJ, REMOVABLE W/ MULTI-AXIAL MOUNT EA. E1028 $3197702 PULL-PIN, FLIP-BACK SHORT W/ L-BRACKET MOUNT EA. E1028 $2967703 PULL-PIN, FLIP-BACK STD W/ MULTI-AXIAL MOUNT EA. E1028 $3437704 PULL-PIN, HEIGHT ADJ, REMOVABLE W/ L-BRACKET MOUNT EA. E1028 $3187708 ROCK-N-ROLL HEIGHT & DEPTH ADJ, REMOVABLE EA. E1028 $4137709 ROCK-N-ROLL HEIGHT & DEPTH ADJ, FLIP-BACK EA. E1028 $4227711 ADJUST-EZE MULTI-ADJUSTABLE, REMOVABLE EA. E1028 $2427715-STD MULTI-AXIS HEADREST HARDWARE -O/S STANDARD EA. E1028 $2147715-LONG MULTI-AXIS HEADREST HARDWARE -O/S LONG EA. E1028 $214

    7733 ADAPTAPLATE - HEADREST HARDWARE ADAPTER PLATE - UNIVERSAL EA. E1028 $66

    77PLATEMATE PLATEMATE HEADREST HARDWARE ADAPTER - OTHER MFGR EA. K0108 $45MOD-7H CURVED MODIFICATION FOR FLAT HEADREST PAD EA. K0108 $87MOD-7J OCCIPITAL LEDGE MODIFICATION TO HEADREST PAD EA. K0108 $134MOD-7K COVER ONLY - HEADREST PAD EA. K0108 $62MOD-7N ELASTIC SLIP COVER - HEADREST EA. $95STAN7 3# FOAM IN HEADREST PAD PER 1" 1" K0108 $27HIGHD7 4# FOAM IN HEADREST PAD PER 1" 1" K0108 $27TUF7 5# FOAM IN HEADREST PAD PER 1" 1" K0108 $36DURA7 10# FOAM IN HEADREST PAD PER 1" 1" K0108 $56TFOAM7 T-FOAM IN HEADREST PAD PER 1" 1" K0108 $36PUDG7 PUDGEE FOAM IN HEADREST PER 1" 1" K0108 $121SUN7 SUNMATE IN HEADREST PAD PER 1" 1" K0108 $42EVA7 EVA FOAM IN HEADREST PAD PER 1" 1" K0108 $9FREE7 FREEFLOAT GEL IN HEADREST PAD PER 1/2" 1/2" K0108 $82WAFFLE7 WAFFLE GEL IN HEADREST PAD PER 1/2" 1/2" K0108 $114ROHO7 ROHO ADAPTER PAD IN HEADREST 13 X 9" 1" K0108 $12409-2000 STANDARD ARM TROUGH-w/T-NUTS EA. K0108 $22509-5000 FOREARM CUFFS PR. K0108 $14209-10000 PADDED UPPER TORSO SUPPORT EA. K0108 $530SFDI-9APH-XS PADDED ARM TROUGH - EXTRA SMALL 10" EA. E2209 $201SFDI-9APH-S PADDED ARM TROUGH - SMALL 12" EA. E2209 $201SFDI-9APH-M PADDED ARM TROUGH - MEDIUM 14" EA. E2209 $201SFDI-9APH-L PADDED ARM TROUGH - LARGE 16" EA. E2209 $201SFDI-9APH-XL PADDED ARM TROUGH - EXTRA LARGE 18" EA. E2209 $201SFDI-9PWSB PADDED WRIST STRAP w/BUCKLE EA. E2209 $38108-1000 THIGH CUFFS PR. K0108 $151108-4000 CALF TROUGHS PR. K0108 $305

  • Rev. 08.01.2020 13 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC Retail108-6000 ANKLE CUFFS PR. K0108 $134108-7000 CALF CUFFS PR. K0108 $134EE8 SOLID CALF PANEL-WOOD/FOAM/HARDWARE EA. K0108 $305EE8A CALF PANEL-FABRIC SLING EA. K0108 $20808-10000 INDIVIDUAL LEG CRADLES - PAIR PR. K0108 $63308-11000 ONE PIECE DOUBLE LEG FOOTBOX EA. K0108 $541SFDI-8CS-S CALF STRAP - SMALL EA. K0038 $54SFDI-8CS-M CALF STRAP - MEDIUM EA. K0038 $59SFDI-8CS-L CALF STRAP - LARGE EA. K0038 $64STAN5 3# FOAM LEG CRADLES/BOX 1" K0108 $36HIGHD5 4# FOAM LEG CRADLES/BOX 1" K0108 $57TUF5 5# FOAM LEG CRADLES/BOX 1" K0108 $79DURA5 10# FOAM LEG CRADLES/BOX 1" K0108 $143TFOAM5 T-FOAM LEG CRADLES/BOX 1" K0108 $150PUDG5 PUDGEE LEG CRADLES/BOX 1" K0108 $334SUN5 SUNMATE LEG CRADLES/BOX 1" K0108 $131EVA5 EVA FOAM LEG CRADLES/BOX 1" K0108 $28FREE5 FREE FLOAT GEL LEG CRADLES/BOX 1/2" K0108 $516WAFFLE 5 WAFFLE FREEFLOAT GEL LEG CRADLES/BOX 1/2" K0108 $516ROHO5-1P ROHO ADAPTOR CUSHIONS INSERT IN LEG CRADLES/BOX - 1 PANEL 1" K0108 $12808-1000 LEXAN TRAY-HOOK/LOOP EA. E0950 $20708-2000 3/8" LEXAN TRAY w/CHANNEL BRACKETS & RIBS EA. E0950 $28508-2500 BIRCH TRAY w/CHANNEL BRACKETS EA. E0950 $24208-4000 1/2" BIRCH TRAY-HOOK/LOOP EA. E0950 $16308-6000 3/8" LEX TRAY ADJUSTABLE KNOB HARDWARE EA. E0950 $23008-6500 BIRCH TRAY-ADJUST w/RIBS EA. E0950 $23008-7000 LEXAN TRAY w/TOGGLES EA. E0950 $28508-7500 BIRCH TRAY-TOGGLES EA. E0950 $24208-8000 3/8" LEXAN TRAY-NO HARDWARE EA. E0950 $16708-8500 1/2" BIRCH TRAY-NO HARDWARE EA. E0950 $16708-12000 EZ-LITE 1/4" LEXAN TRAY w/CHANNEL BRACKETS EA. E0950 $17908-13000 EZ-LITE 1/4" LEXAN TRAY 1/4" w/RIBS EA. E0950 $19208-16000 1/4" LEXAN TRAY w/HOOK AND LOOP MOUNTING EA. E0950 $11108-17000 1/4" LEXAN TRAY - NO HARDWARE EA. E0950 $100MOD-8A 3/8" LEXAN MATERIAL SUBSTITUTE EA. K0108 $67MOD-8A1 1/4" BOLTARON MATERIAL SUBSTITUTE EA. K0108 $51MOD-8A2 3/8" BOLTARON MATERIAL SUBSTITUTE EA. K0108 $101MOD-8B 1/4" BLACK ABS PLASTIC EA. K0108 $50MOD-8C JOYSTICK / POWER CUT OUT EA. K0108 $91MOD-8G ALUMINUM RIM EA. K0108 $57MOD-8H PLASTIC RIM GUARD EA. K0108 $37MOD-8J REAR STABILITY BELT EA. K0108 $41MOD-8K ELBOW BLOCKS-L BRACKET PR. K0108 $249MOD-8L PAD TRAY-TOP ONLY EA. K0108 $316MOD-8L1 PAD TRAY-TOP & BOTTOM EA. K0108 $526MOD-8M PAD HALF TRAY EA. K0108 $266MOD-8N RIBS-WOOD, LEX. ALUM SET K0108 $50MOD-8O ELBOW PADS-HOOK/LOOP PR. K0108 $116MOD-80W ELBOW PADS w/WOOD BASE PR. K0108 $198MOD-8P OVERLAY EA. K0108 $121MOD-8Q UNDERLAY EA. K0108 $121

  • Rev. 08.01.2020 14 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC RetailMOD-8R REMOVABLE EASEL EA. K0108 $233MOD-8S TRAY TRIM EA. K0108 $37MOD-8T SLIP COVER - TRAY PADDING EA. K0108 $235STAN8 3# FOAM FULL TRAY PAD TOP OR BOTTOM EA. K0108 $120HIGHD8 4# FOAM FULL TRAY PAD TOP OR BOTTOM EA. K0108 $120DURA8 10# FOAM FULL TRAY PAD TOP OR BOTTOM EA. K0108 $188TUF8 5# FOAM FULL TRAY PAD TOP OR BOTTOM EA. K0108 $139SUN8 SUN FOAM FULL TRAY PAD TOP OR BOTTOM EA. K0108 $184TFOAM8 T-FOAM FULL TRAY PAD TOP OR BOTTOM EA. K0108 $192PUDG8 PUDG FOAM FULL TRAY PAD TOP OR BOTTOM EA. K0108 $334FREE8 FREE FLOAT FULL TRAY PAD TOP OR BOTTOM EA. K0108 $708WAFFLE8 WAFFLE GEL FULL TRAY PAD TOP OR BOTTOM EA. K0108 $567EE9 SHOE HOLDERS w/VELCRO PR. K0108 $174EE9B HI-TOPS PR. K0108 $117EE9B-D HI-TOPS DYNAMIC PR. K0108 $117EE9C SHOE HOLDERS w/BUCKLES PR. K0108 $174EE9D-2 HEEL LOOPS PR. K0108 $68EE9F HI-TOPS 3-POINT STATIC PR. K0108 $177EE9F-D HI-TOPS 3-POINT DYNAMIC PR. K0108 $177EE9G SHOE HOLDERS w/BUCKLES & COMBINATION VELCRO STRAPS PR. K0108 $174EE9H FOOT AND ANKLE STABLIZER PR. K0108 $221SFDI-9BV-XS HI-TOPS - VELCRO - EXTRA SMALL EA. K0108 $123SFDI-9BV-S HI-TOPS - VELCRO - SMALL EA. K0108 $123SFDI-9BV-M HI-TOPS - VELCRO - MEDIUM EA. K0108 $128SFDI-9BV-L HI-TOPS - VELCRO - LARGE EA. K0108 $128SFDI-9BV-XL HI-TOPS - VELCRO - EXTRA LARGE EA. K0108 $134SFDI-9BB-XS HI-TOPS - BUCKLE - EXTRA SMALL EA. K0108 $123SFDI-9BB-S HI-TOPS - BUCKLE - SMALL EA. K0108 $123SFDI-9BB-M HI-TOPS - BUCKLE - MEDIUM EA. K0108 $128SFDI-9BB-L HI-TOPS - BUCKLE - LARGE EA. K0108 $128SFDI-9BB-XL HI-TOPS - BUCKLE - EXTRA LARGE EA. K0108 $134MOD-9A RE-COVER ARMREST PADS PR. K0108 $96MOD-9B ANKLE STRAPS w/PADS PR. K0108 $56MOD-9B-B ANKLE STRAPS w/BUCKLES & PADS PR. K0108 $56MOD-9C ANKLE STRAPS-PADS ONLY PR. K0108 $38MOD-9D TOE STRAPS-NO PADS PR. K0108 $30MOD-9D-B TOE STRAPS w/BUCKLES PR. K0108 $30MOD-9E PAD INSIDE SHOEHOLDERS PR. K0108 $303MOD-9F ARMREST PADS ONLY PR. K0108 $207MOD-9G FOOTPLATE PADS w/H&L PR. K0108 $169MOD-9GW FOOTPLATE PADS w/WOOD BASE PR. K0108 $212MOD-9I SLIP COVER - FOOTBOX/LEG CRADLE EA. $223MOD-9K FOOTBOARD PAD w/HOOK & LOOP EA. $169MOD-9X FOOTBOX/LEG CRADLES, PADS ONLY EA. $9910-1000 CUSTOM CUSHION EA. QUOTESTAN10 3# FOAM IN CUSHION K0108 $47HIGHD10 4# FOAM IN CUSHION K0108 $47TUF10 5# FOAM IN CUSHION K0108 $55DURA10 10# FOAM IN CUSHION K0108 $89SUN10 SUNMATE FOAM IN CUSHION K0108 $77TFOAM10 T-FOAM IN CUSHIO K0108 $93

  • Rev. 08.01.2020 15 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC RetailPUDG10 PUDGEE FOAM IN CUSHIO K0108 $200FREE10 FREE FLOAT GEL FOAM - 18 x 16 & UNDER K0108 $318FREE10OVER FREE FLOAT GEL FOAM - OVER 18 x 16 K0108 $644WAFFLE10 WAFFLE FREE FLOAT GEL FOAM - 18 X 16 & UNDER K0108 $257WAFFLE10OVER WAFFLE FREE FLOAT GEL FOAM - OVER 18 X 16 K0108 $516EVA10 EVA FOAM IN CUSHION K0108 $46

    ROHO10-12ROHO ADAPTOR CUSHION INSERT - 1" CELLS - MAX SIZE 13" X 9" - ISCHIAL RELIEF

    K0108 $122

    ROHO10-13ROHO ADAPTOR CUSHION INSERT - 1" CELLS - MAX SIZE 13" X 9" - COCCYGIAL RELIEF

    K0108 $122

    MOD-10OVER18 SEAT OVER 18W OR 18D EA. E2609 $70MOD-10OVER22 SEAT OVER 21W OR 21D EA. E2609 $95MOD-10OVER24 SEAT OVER 24W OR 24D EA. E2609 $118

    MOD-10ECUSTOM CUSHION COVER MADE OF NAUGHAHYDE, SAILCLOTH, LYCRA, NEOPRENE, DARLEX OR CORDURA. KNIT COVERS ARE STANDARD

    EA. K0108 $101

    MOD-10Q NON-SKID BASE EA. K0108 $27MOD-10X APPLEWOOD CUSHION BASE EA. E0992 $71MOD-10X1 1/4" BOLTERON CUSHION BASE EA. K0108 $14411-1000 VENT TRAY EA. E1029 $50611-1000C VENT TRAY-HINGED-QUICK RELEASE EA. E1029 $55411-2000 O2 TANK HOLDER-UPHOLSTERED EA. K0108 $20711-3000 O2 TANK HOLDER-ALUMINUM FIXED HARDWARE EA. K0108 $22711-3100 O2 TANK HOLDER-ALUMINUM QUICK RELEASE HARDWARE EA. K0108 $54811-3000A O2 TANK HOLDER-ALUMINUM NO HARDWARE EA. K0108 $20711-584 02 TANK QUICK RELEASE HARDWARE MOUNTING KIT KIT $34111-4000 IV POLE-QUICK RELEASE w/MOUNTING HARDWARE EA. K0105 $27011-5000 BATTERY TRAY FIXED HARDWARE EA. K0108 $49611-6000 BATTERY TRAY QUICK RELEASE HARDWARE EA. K0108 $584MOD-11A 02 TANK HOLDER STRAP EA. K0108 $150FBP BACKPACK EA. K0108 $83FHP HIP POUCH EA. K0108 $50FMNP MEDICAL NECESSITIES POUCH EA. K0108 $83403A SPLIT COLLAR CLAMP 1" DIAMETER EA. K0108 $36403AM SPLIT COLLAR CLAMP 1" DIAMETER MILL EA. K0108 $36403B SPLIT COLLAR CLAMP 7/8" DIAMETER EA. K0108 $36403BM SPLIT COLLAR CLAMP 7/8" DIAMETER MILL EA. K0108 $36403C SPLIT COLLAR CLAMP 3/4" DIAMETER EA. K0108 $36403CM SPLIT COLLAR CLAMP 3/4" DIAMETER MILL EA. K0108 $36405A1 1" DROP HOOK - ALUMINUM EA. K0108 $27405S1A 1" DROP HOOK - STAINLESS EA. K0108 $27406A1 2" DROP HOOK - ALUMINUM EA. K0108 $29406S1 2"DROP HOOK - STAINLESS EA. K0108 $29407A1 3" DROP HOOK - ALUMINUM EA. K0108 $32407S1 3" DROP HOOK - STAINLESS EA. K0108 $32408 NEW STYLE U CLAMP EA. K0108 $36410 WASHER CLAMP - MILLED EA. K0108 $48411 WASHER CLAMP EA. K0108 $39413A L-BRACKET - ALUMINUM EA. K0108 $36413S L BRACKET - STAINLESS EA. K0108 $36414A J-HOOK - ALUMINUM EA. K0108 $36

  • Rev. 08.01.2020 16 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC Retail414S J-HOOK - STAINLESS EA. K0108 $36415A J & L w/FASTENERS - ALUMINUM EA. K0108 $70415S J & L w/FASTENERS - STAINLESS EA. K0108 $70416 BALL BASE MILLED EA. K0108 $48418 BALL BASE EA. K0108 $39424-2 ABDUCTOR BRACKET - FLIP (EE3B) EA. E1028 $260430 SEAT TO BACK HINGE - OFFSET EA. K0108 $311430A SEAT TO BACK HINGE - FLUSH EA. K0108 $311430B FLIP AND FOLD SEAT TO BACK BRACKET STANDARD SIZE EA. K0108 $311430C FLIP AND FOLD SEAT TO BACK BRACKET CHILD SIZE EA. K0108 $311431 BOTTOM EE HEADREST BR EA. K0108 $50436 CLAMP - 30° EA. K0108 $24437B BACK MOUNT BRACKET - HINGED EA. K0108 $29437C BACK MOUNT BRACKET - EE- 2 SLOT - PEDIATRIC EA. K0108 $29437A-L BACK MOUNT BRACKET ECONO EZE LEFT EA. K0108 $20437-PIN-L BACK MOUNT BRACKET PIN LOCK EE LEFT EA. K0108 $61437A-R BACK MOUNT BRACKET ECONO EZE RIGHT EA. K0108 $20437-PIN-R BACK MOUNT BRACKET PIN LOCK EE RIGHT EA. K0108 $61437A-2 BACK MOUNT BRACKET ECONO EZE PR. K0108 $41437-PIN-2 BACK MOUNT BRACKET PIN LOCK EE PR. K0108 $122450A L BRACKET - DUAL SLOT LAT. SUPPORT EA. K0108 $29438 ABDUCTOR BRACKET - SLIDE IN EA. E1028 $28439-1 SEAT MOUNT BRACKET ECONO EZE EA. K0108 $29439-PIN-1 SEAT MOUNT BRACKET PIN LOCK EE EA. K0108 $61439-2 SEAT MOUNT BRACKET ECONO EZE PR. K0108 $58439-PIN-2 SEAT MOUNT BRACKET PIN LOCK EE PR. K0108 $122442 1" OFFSET FIXED LAT. SUPPORT EA. K0108 $32442A 1" OFFSET EXTENDED - FIXED LAT. SUPPORT EA. K0108 $70442C 1" OFFSET-SUMMER/WINTER FXD LAT SUP EA. E1028 $111443 2" OFFSET FIXED LAT. SUPPORT EA. K0108 $32443B 2" OFFSET EXTENDED - FIXED LAT SUPPORT EA. K0108 $70443C 2" OFFSET-SUMMER/WINTER FXD LAT SUP EA. E1028 $117445 FLAT DUAL SLOT BRACKET(MULTI APPLICATION) EA. K0108 $46450B L BRACKET - DUAL SLOT LAT. SUP. EXT. EA. K0108 $70450C L BRACKET-SUMMER/WINTER LAT. SUPPORT EA. E1028 $111451 L-BRACKET TRUNK MOUNT EA. K0108 $55452 TOP HEADREST BRACKET EA. K0108 $46453A ABDUCTOR BRACKET-FLIP-LONG (EE3E) EA. E1028 $226454A ADJ. KNOB RELEASE TRAY MTG. HDWR EA. E1028 $54454B TOGGLE CLAMP REL TRAY MTG. HDWR EA. E1028 $129454C MOUNTING STRAPS TRAY HARDWARE EA. K0108 $42455A LOCKING S/A THOR. LAT. SUP. SHORT ASSEM EA. E1028 $154455B LOCKING S/A THOR. LAT. SUP. LONG ASSM EA. E1028 $154455C LOCKING S/A THOR LAT SUP 1" O/S ASSM EA. E1028 $154455D-L LIFT S/A LAT THOR 2" O/S HARDWARE LT EA. E1028 $154455D-R LIFT S/A LAT THOR 2" O/S HARDWARE RT EA. E1028 $154455D-2 LIFT S/A LAT THOR 2" O/S HARDWARE PR. E1028 $309456A Q.R. LAT. SUP. L-BRACKET ASSEMBLY EA. E1028 $148456AE Q.R. LAT. SUP. L-BRACKET ASSEMBLY - EXTENDED EA. E1028 $188456B Q.R. LAT. SUP. 1" OFFSET ASSEMBLY EA. E1028 $148456BE Q.R. LAT. SUP. 1" OFFSET ASSEMBLY - EXTENDED EA. E1028 $188

  • Rev. 08.01.2020 17 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC Retail456D Q.R. LATERAL SUPPORT RECEIVER BRKT EA. E1028 $109456E Q.R. LATERAL SUPPORT PLATE L-BRKT. EA. E1028 $39456EE Q.R. LATERAL SUPPORT PLATE L-BRKT. - EXTENDED EA. E1028 $78456F Q.R. LATERAL SUPPORT PLATE 1" OFFSET EA. E1028 $39456FE Q.R. LATERAL SUPPORT PLATE 1" OFFSET - EXTENDED EA. E1028 $78456H-B PULL KNOB 1/4 TURN - BLACK EA. E1028 $40457 Q.R. RELEASE LEV CLAMP EA. E1028 $58460B HEAVY DUTY FLIP TOP PLATE EA. E1028 $44461 CHANNEL BRACKET TRAY MOUNTING HARDWARE EA. K0108 $69462A FRAME CLAMPS - EE STANDARD ROUND PR. K0108 $290462B FRAME CLAMPS-EE - SQ. - THRU FRAME PR. K0108 $290462C FRAME CLAMP EE SQ. AROUND FRAME PR. K0108 $290463G HEAVY DUTY HINGE EA. K0108 $57464A SINGLE TRACK - 11" EA. K0108 $53464B SINGLE TRACK - 9" EA. K0108 $53464C SINGLE TRACK - 7" (STANDARD) EA. K0108 $53464D SINGLE TRACK - 5" EA. K0108 $53464E SINGLE TRACK - 3" EA. K0108 $53464F DOUBLE TRACKS 5" EA. K0108 $59464H DOUBLE TRACKS - 9" EA. K0108 $59464I DOUBLE TRACKS - 11" EA. K0108 $59466 4" SLOTTED BRACKET EA. K0108 $36468A THOR.LAT.SUP.FIXED BACK POST MNT 1" EA. K0108 $128478A HEADREST/ARMREST POST EA. E1028 $155478C PULL KNOB ASSEMBLY HEADREST& ARMREST POST EA. E1028 $151480 SPACER-SINGLE SLOT-1/4" PR E1028 $20481 SPACERS FOR CHANNEL BR EA. K0108 $16482 SPACER - DUAL SLOT - 1/2" PR. K0108 $20483 SPACER-DUAL SLOT - 1/4" PR. K0108 $20484A T-NUT - 1/4-20 EA. K0108 $1484B T-NUT - 7/16-16 EA. K0108 $1484C TRACK NUTS EA. K0108 $1485A BEE STINGER - 1/4-20 EA. K0108 $1485B BEE STINGER - 7/16-16 EA. K0108 $1486A S/A TRUNK PLATE SHORT EA. E1028 $63486A-L S/A LAT SUP FRONT MNT PLATE-SHORT FOR LEVER EA. E1028 $63486B S/A LAT SUP FRONT MOUNT PLATE - LONG EA. E1028 $104486B-L S/A LAT SUP FRONT MOUNT PLATE - LONG FOR LEVER EA. E1028 $104486C S/A LAT SUP FRONT MOUNT PLATE 1" O/S EA. E1028 $63486C-L-L S/A LAT SUP FRONT MOUNT PLATE 1" O/S - LEVER, LEFT EA. E1028 $63486C-L-R S/A LAT SUP FRONT MOUNT PLATE 1" O/S - LEVER, RIGHT EA. E1028 $63486D S/A LAT SUP FRONT MOUNT PLATE 2" O/S EA. E1028 $63486D-L-L S/A LAT SUP FRONT MOUNT PLATE 2" O/S - LEVER, LEFT EA. E1028 $63486D-L-R S/A LAT SUP FRONT MOUNT PLATE 2" O/S - LEVER, RIGHT EA. E1028 $63487A STAR KNOB - NO STEM EE S & B EA. E1028 $19487B STAR KNOB - 3/8" - 16 HEADREST EA. K0108 $18487C STAR KNOB - 1" STEM FOR OXYGEN TANK HOLDER EA. K0108 $19487D STAR KNOB - 3/4" STEM FOR OXYGEN TANK HOLDER EA. K0108 $19488 ECONO-EZE CLAMP ONLY EA. K0108 $156489A SPREADER BAR 10-11"W CHAIR EA. K0108 $36489B SPREADER BAR 12-13"W CHAIR EA. K0108 $36

  • Rev. 08.01.2020 18 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC Retail489C SPREADER BAR 14-15" W CHAIR EA. K0108 $36489D SPREADER BAR 16-17" W CHAIR EA. K0108 $36489E SPREADER BAR 18-19" W CHAIR EA. K0108 $36489F SPREADER BAR 20"W & LARGER CHAIR EA. K0108 $36492 L-BRACKET SINGLE CRESCENT BACK MOUNTING EA. K0108 $48492S L-BRACKET SINGLE CRESCENT STAINLES STEEL BACK MOUNTING EA. K0108 $46493 EXT'D L'S-6 HOLES S/B EA. K0108 $46495 KEEPER PLATE LATERAL SUPPORT EA. K0108 $29496A LATERAL SUPPORT - HINGE - LOCKING, LIFT STYLE EA. E1028 $121496A-L LATERAL SUPPORT - HINGE - LOCKING, LEVER STYLE EA. E1028 $121496C S/A LAT. SUP. REAR MOUNT PLATE SLOT EA. E1028 $63496D S/A LAT SUP REAR MT PLATE SUMMER/WINTER EA E1028 $81497A LOCK S/A THOR. LAT SUMMER/WINTER SHORT ASSEMBLY EA. E1028 $227497B LOCK S/A THOR. LAT SUMMER/WINTER LONG ASSEMBLY EA. E1028 $267497C LOCK S/A THOR LAT SUMMER/WINTER 1" O/S ASM EA. E1028 $227497D LOCK S/A THOR LAT SUMMER/WINTER 2" O/S ASM EA. E1028 $227497F PUSH BUTTON S/A HINGE FOR EE5W EA E1028 $121498 PULL KNOB w/BLOCK SUMMER/WINTER EA. E1028 $88504A EZ LITE CLAMP - 1" DIAM. EA. E1028 $45504B EZ-LITE CLAMP-WIDE EA. K0108 $45509 NUTS/BOLT KIT EA. K0108 $170510A-L S/A LEVER RELEASE LAT THOR L HARDWARE LT EA. E1028 $176510A-R S/A LEVER RELEASE LAT THOR L HARDWARE RT EA. E1028 $176510A-2 S/A LEVER RELEASE LAT THOR L HDWE PR. E1028 $353510B-L S/A LEVER RELEASE LAT THOR 1" OFFSET LT EA. E1028 $176510B-R S/A LEVER RELEASE LAT THOR 1" OFFSET RT EA. E1028 $176510B-2 S/A LEVER RELEASE LAT THOR 1" OFFSET PR. E1028 $353510C-L S/A LEVER RELEASE LAT THOR 2" OFFSET LT EA. E1028 $176510C-R S/A LEVER RELEASE LAT THOR 2" OFFSET RT EA. E1028 $176510C-2 S/A LEVER RELEASE LAT THOR 2" OFFSET PR. E1028 $353510D-L S/A LEVER RELEASE LAT THOR L HARDWARE EXT. LT EA. E1028 $216510D-R S/A LEVER RELEASE LAT THOR L HARDWARE EXT. RT EA. E1028 $216510D-2 S/A LEVER RELEASE LAT THOR L HARDWARE EXT. PR. E1028 $433511A-L S/A LEVER RELEASE SUMMMER/WINTER LAT THOR L BRACKET LT EA. E1028 $246511A-R S/A LEVER RELEASE SUMMMER/WINTER LAT THOR L BRACKET RT EA. E1028 $246511A-2 S/A LEVER RELEASE SUMMMER/WINTER LAT THOR L BRACKET PR. E1028 $491511C S/A LEVER RELEASE w/SUMMER/WINTER-2" OFFSET EA. E1028 $246511D S/A LEVER RELEASE w/SUMMER/WINTER-EXTND EA. E1028 $285520 GLIDE LOCK HARDWARE EA. K0108 $58521 LEG CRADLE MOUNT CLAMP w/FLAT BRKT PR. K0108 $290543 HIDE AWAY ABDUCTOR HARDWARE ONLY EA. E1028 $260549 L BRACKET FOR EASY CONFORMING BACK - ALUMINUM EA. K0108 $46549S L BRACKET FOR EASY CONFORMING BACK - STAINLESS STEEL EA. K0108 $46555 J/L FOR EASY CONFORMING BACK - ALUMINUM EA. K0108 $82555S J/L FOR EASY CONFORMING BACK - STAINLESS STEEL EA. K0108 $82556 QUICK RELEASE I.V. POLE HARDWARE EA. K0108 $154557 EE1 ALL ADJ SEAT HARDWARE EA. K0108 $222558 EE2 ALL ADJ SEAT HARDWARE EA. K0108 $222559 ADJUSTABLE CHANNEL BRACKET FOR EZ LITE TRAY EA. K0108 $69563 Q.R. HINGED DROP HOOK FOR VENT KIT E1028 $286565 ABDUCTOR KEEPER PLATE EA. K0108 $16

  • Rev. 08.01.2020 19 of 25 Form No. SOSPPL

    Part Number Description UOM HCPC Retail566 EASY CLAMP SEAT AND BACK MOUNTING HARDWARE 1" EA. K0108 $92567 EASY CLAMP w/L BRACKET EA. K0108 $128568 STOPPER RING FOR EASY CLAMP EA. K0108 $14582A L BRACKET DUAL SLOT 4 X 4" EA. K0108 $29582B L BRACKET DUAL SLOT 6 X 4" EA. K0108 $36583 RATCHET LEVER 1/4-20 X 1-1/4" EA. K0108 $13583A FASTCLAMP PLASTIC 1" W/ 4X4 L EA. K0108 $84583B FASTCLAMP PLSTC CLAMP ONLY 1" EA. K0108 $54584 O2 Q.R. HRDWRE- 462, 437A EA. K0108 $341584A FASTCLAMP PLSTC 7/8" W/ 4X4 L EA. K0108 $84584B FASTCLAMP PLSTC CLMP ONLY 7/8" EA. K0108 $54585 3/4" TRIGLIDE WEBBING ADJUSTER EA. K0108 $2585A FASTCLAMP ALU 1" W/ 4X4 L EA. K0108 $84585B FASTCLAMP ALU CLAMP ONLY 1" EA. K0108 $54586 1" TRIGLIDE WEBBING ADJUSTER EA. K0108 $3586A FASTCLAMP ALU 7/8" W/ 4X4 L EA. K0108 $84586B FASTCLAMP ALU 7/8" NO L Bracket EA. K0108 $54587 1-1/2" TRIGLIDE WEBBING ADJUST EA. E1028 $4587A PSH BTN S/A T/S HDWE 1" O/S EA. E1028 $154587B PSH BTN S/A T/S HDW 1" O/S EXT EA. E1028 $194588 2" TRIGLIDE WEBBING ADJUSTER EA. E1028 $5588A PSH BTN S/A T/S HDWE 2" O/S EA. E1028 $154588B PSH BTN S/A T/S HDW 2" O/S EXT EA. E1028 $194589A PSH BTN S/A T/S HDWE 0" 0/S EA. E1028 $154589B PSH BTN S/A T/S HDWE 0" EXT EA. E1028 $194590A TODDLER FASTCLAMP ADJ ASSY 1" EA. E1028 $84591 RATCHET LEVER 8 X 10MM (7715) EA. E1028 $13592 HANGER MOINTED ADUCTOR HARDWARE ASSEMBLY EA. E1028 $170593 ROCK N ROLL MOUNT BLOCK ASSY EA. E1028 $198PSRB PLASTIC SIDE RELEASE BUCKLE 1" EA. E1028 $8PSRB15 PLASTIC SIDE RELEASE BUCKLE 1.5" EA. E1028 $13PSRB2 PLASTIC SIDE RELEASE BUCKLE 2" EA. E1028 $16

  • Rev. 08.01.2020 20 of 25 Form No. WOPROPL

    Item No. Description HCPCS RETAIL11-1100-12 VENT BRKT FLDNG BK PST MNT 12W E1029 $550.00PRO-10900 FREEDOM BACKPACK $60.00PRO-10905-12 CANOPY - FLIP-BACK ADJ 12-14W $0.00PRO-10917 WHEELCHAIR TOOL KIT - INTL $40.00PRO-10920 TILT RANGE LIMIT KIT $35.00PRO-20W 20" WIDE SEAT FRAME E2201 $500.00PRO-23210 FLIP DOWN RIGIDIZING BAR $175.00PRO-30275 HAND ACTIV BRAKE/WHL LCK SYSTM E1228 $1,000.00PRO-30279 POP-UP SWING AWAY ELR ASSY K0195 $295.00PRO-30291-2 CONTRACTURE FTRST SHORT - 11" TO 15" $3,570.00PRO-30292-2 CONTRACTURE FTRST LONG - 15" TO 19" $3,570.00PRO-30297-2 3D DYNAMIC FTRST ASSY HI PIVOT $6,215.00PRO-30298-2 3D DYNAMIC FTRST ASSY STD $5,775.00PRO-30300 PRO-CG PED RIGID TRANS OPT E1233 $2,800.00PRO-30301 PRO-CG PED RIGID TRANS INCL E1233 $3,050.00PRO-30302 PRO-CG SE PED RIGID TRANS OPT E1233 $2,625.00PRO-30310 PRO-CG ADULT RIGID TRANS OPT E1161 $2,990.00PRO-30311 PRO-CG ADULT RIGID TRANS INCL E1161 $3,300.00PRO-30312 PRO-CG SE ADULT RIGID TRNS OPT E1161 $2,775.00PRO-30313 PRO-CG SC ADULT RIGID TRNS OPT E1161 $3,465.00PRO-30314 PRO-CG SC ADULT RIGID TRNS INC E1161 $3,715.00PRO-30324 LEAF SEAT FRAME PAIR $775.00PRO-30325 SRO - SEAT RAIL ONLY PAIR $325.00PRO-30335 VENT TRAY BASE WITH TRAY E1029 $589.00PRO-30517 INDIV STROLLER HNDL EXT REMOV $110.00PRO-30525 2" SEAT RAIL EXTENSIONS $41.00PRO-30528 20" SEAT DEPTH E2203 $550.00PRO-30529 21" SEAT DEPTH E2203 $550.00PRO-30531 4" SEAT RAIL EXTENSIONS $41.00PRO-30535 22" SEAT DEPTH E2204 $990.00PRO-30536 23" SEAT DEPTH E2204 $990.00PRO-30537 24" SEAT DEPTH E2204 $990.00PRO-30538 25" SEAT DEPTH E2204 $990.00PRO-30539 26" SEAT DEPTH K0108 $990.00PRO-30542 DYNAMIC ROCKER BACK/B.P. TUBES $1,985.00PRO-30562 SRRSB RECLINE BKRST ASSY E1226 $1,133.00PRO-30564 SRRSB RECLINE BKRST w/PBSH $1,335.00PRO-30571 PSH-BTN, ANG-ADJ STRLR-STD $112.00

    PRO-CG Wheelchair Price ListFreedom Designs

    2241 Madera Rd. Simi Valley, CA 93065800.331.8551 || www.freedomdesigns.com

    || [email protected]

  • Rev. 08.01.2020 21 of 25 Form No. WOPROPL

    Item No. Description HCPCS RETAILPRO-30576 PSH-BTN, ANG-ADJ STRLR-HD $179.00PRO-30590 REMOVABLE ADJUSTABLE STRLR HND $95.00PRO-31000 PNEUMATIC TIRE WITH AIRLESS INSERT E2211 + E2213 $85.00PRO-31005 PLASTIC COATED HANDRIMS E2205 $119.00PRO-31040 PNEUMATIC TIRE E2211 + E2212 $85.00PRO-31045 LOW PROFILE POLYURETHANE TIRE $0.00PRO-31508 FOOT ACTIVATED WHEEL LOCK ASSY $200.00PRO-31530 16" MAG WHEEL $41.00PRO-31533 18" MAG WHEEL $41.00PRO-31540 20" SPOKE WHEEL - ALUMINUM HANDRIM $204.00PRO-31541 22" SPOKE WHEEL - ALUMINUM HANDRIM $204.00PRO-31542 24" SPOKE WHEEL - ALUMINUM HANDRIM $204.00PRO-31600 CURB ASSIST ANTI-TIP ASSY ADJ E0971 $125.00PRO-31605 SWING-AWAY ANTI-TIPPERS FT ACT E0971 $180.00PRO-31801 WHEEL LOCK EXTENSION HANDLES E0961 $75.00PRO-34200 7" X 2" POLY CASTER (8" X 2") $200.00PRO-34222 5" X 1.5" POLY PLASTIC MAG CST $87.00PRO-34444 6" X 2" POLY WITH TREAD $97.00PRO-34999 6" X 1.5" POLY PLASTIC MAG $87.00PRO-35050 5" LIGHT UP POLYURETHAN CASTER $101.00PRO-36022 HEEL LOOPS E0951 $45.00PRO-36024 CALF STRAP - WEBBING K0038 $45.00PRO-36029 ANGLE ADJ REM FOOTBOARD ASSY K0040 $190.00PRO-36033 ALUMINUM ANGLE ADJ FLIP-UP K0040 $190.00PRO-36040 MAPS - MULTI AXIS POS SYS PAIR $325.00PRO-36402 4.5" HEAVY DUTY EXTENSION $58.00PRO-36403 6.5" HEAVY DUTY EXTENSION $68.00PRO-36410 HIGH CLAMP & TUBES $102.00PRO-38200 13.5" LOCKING FLIP BACK ARMS E0973 $265.00PRO-38201 10.5" LOCKING FLIP BACK ARMS E0973 $265.00PRO-38203 SINGLE POST HGHT ADJ REM TALL E0973 $285.00PRO-38206 DUAL POST FLIP UP HGHT-ADJ REM E0973 $295.00PRO-38210 10.5"-13.5" FLIP BCK TELES LCK E0973 $285.00PRO-38215 17"-20" FLIP BCK TELESC LCKING E0973 $285.00PRO-38217 SINGLE POST HGHT ADJ REM SHORT E0973 $285.00PRO-39010 FIXED SOLID SEAT PAN - PLST E2231 $170.00PRO-39030-1214 FIXED SLD SEAT PAN - ALU 12X14 E2231 $200.00PRO-39030-1416 FIXED SLD SEAT PAN - ALU 14X16 E2231 $200.00PRO-39030-1618 FIXED SLD SEAT PAN - ALU 16X18 E2231 $200.00PRO-39030-1818 FIXED SLD SEAT PAN - ALU 18x18 E2231 $200.00PRO-39040-1414 FXD, ADJ ALU ST PN 12-14X14 E2231 $290.00PRO-39040-1616 FXD, ADJ ALU ST PN 14-16X16 E2231 $290.00PRO-39040-1818 FXD, ADJ ALU ST PN 16-18X18 E2231 $290.00PRO-42000 5" X 1.4" POLY ALUMINUM MAG $170.00PRO-43000 4" X 1.4" POLY ALUMINUM MAG $170.00

  • Rev. 08.01.2020 22 of 25 Form No. WOPROPL

    Item No. Description HCPCS RETAILPRO-44000 6 X 1.4" POLY ALUMINUM MAG $170.00PRO-99997 TRANSPORT OPTION - SE $300.00PRO-99998 TRANSPORT OPTION $300.00PRO-DROP1 1" DROP PAN HARDWARE KIT $207.00PRO-DROP2 2" DROP PAN HARDWARE KIT $207.00PRO-EZLITE REM SEAT PAN HDWE KIT 4-PT $207.00SFDI-9HP FOOTREST HANGER PADS - PAIR $92.00

  • Rev. 08.01.2020 23 of 25 Form No. WONXTPL

    Item No. Description HCPCS RETAILNXT-10900 BACKPACK - FREEDOM BACKPACK $60.00NXT-10905-10 CANOPY - FLIP-BACK ADJ 10-12W $0.00NXT-10917 WHEELCHAIR TOOL KIT - INTL $40.00NXT-23210 FLIP DOWN RIGIDIZING BAR $175.00NXT-30264 20" WIDE FRAME E2201 $500.00NXT-30275 HAND ACTIV BRAKE/WHL LCK SYSTM E2228 $0.00NXT-30279 POP-UP SWING AWAY ELR ASSY K0195 $295.00NXT-30291-2 CONTRACTURE FTRST SHORT PR $3,570.00NXT-30292-2 CONTRACTURE FTRST LONG PR $3,570.00NXT-30297-2 3D DYNAMIC FTRST ASSY HI PIVOT $6,215.00NXT-30298-2 3D DYNAMIC FTRST ASSY STD $5,775.00NXT-30300 NXT PEDIATRIC FOLDING TRNS OPT E1234 $2,850.00NXT-30301 NXT PEDIATRIC FOLDING TRNS INC E1234 $2,995.00NXT-30302 NXT ADULT FOLDING TRNS OPTION E1161 $3,025.00NXT-30303 NXT ADULT FOLDING TRANS INCL E1161 $3,175.00NXT-30304 NXT-SE PEDI FOLDING TRANS OPT E1234 $2,700.00NXT-30305 NXT-SE ADULT FOLDING TRANS OPT E1161 $2,875.00NXT-30310 NXT PEDIATRIC RIGID TRANS OPT E1233 $2,725.00NXT-30311 NXT PEDIATRIC RIGID TRANS INCL E1233 $2,875.00NXT-30312 NXT ADULT RIGID TRANSPORT OPT E1161 $3,025.00NXT-30313 NXT ADULT RIGID TRANSPORT INCL E1161 $3,175.00NXT-30314 NXT-SE PEDIATRIC RIGID TRN OPT E1233 $2,550.00NXT-30315 NXT-SE ADULT RIGID TRNSPRT OPT E1161 $2,875.00NXT-30324 LEAF SEAT FRAME PAIR $775.00NXT-30325 SRO - SEAT RAIL ONLY PAIR $325.00NXT-30327 15 DEG ABDUCTED 75 DEG LEGREST $160.00NXT-30330 NXT-MINI PED FOLDING TRANS OPT E1234 $2,850.00NXT-30331 NXT-MINI PED FOLDING TRANS INC E1234 $2,995.00NXT-30332 NXT-SC ADULT FOLDING TRANS OPT E1161 $3,465.00NXT-30333 NXT-SC ADULT FOLDING TRANS INC E1161 $3,715.00NXT-30340 NXT-MINI PED RIGID TRANS OPT E1233 $2,725.00NXT-30341 NXT-MINI PED RIGID TRANS INC E1233 $2,875.00NXT-30342 NXT-SC ADULT RIGID TRANS OPT E1161 $3,465.00NXT-30343 NXT-SC ADULT RIGID TRANS INC E1161 $3,715.00NXT-30372 75 DEG FIXED LEGREST EXTENDED $45.00NXT-30373 85 DEG FIXED LEGREST EXTENDED $45.00NXT-30517 INDIV STROLLER HNDL EXT REMOV $110.00NXT-30520P PED LONG FRAME W/TALL TILT $165.00NXT-30525 2" SEAT RAIL EXTENSIONS $41.00NXT-30528 20" FRAME DEPTH E2203 $550.00NXT-30529 21" FRAME DEPTH E2203 $550.00

    NXT Wheelchair Price ListFreedom Designs

    2241 Madera Rd. Simi Valley, CA 93065800.331.8551 || www.freedomdesigns.com

    || [email protected]

  • Rev. 08.01.2020 24 of 25 Form No. WONXTPL

    Item No. Description HCPCS RETAILNXT-30531 4" SEAT RAIL EXTENSIONS $41.00NXT-30532 SEATING DYNAMICS ROCKER BACK E2398 $1,985.00NXT-30535TP 22" FRAME DEPTH E2204 $990.00NXT-30537TP 23" FRAME DEPTH E2204 $990.00NXT-30538TP 24" FRAME DEPTH E2204 $990.00NXT-30542TP 25" FRAME DEPTH E2204 $990.00NXT-30543TP 26" FRAME DEPTH $990.00NXT-30570 PSH-BTN, ANG-ADJ STRLR-STD $112.00NXT-30575 PSH-BTN, ANG-ADJ STRLR-HD $179.00NXT-30590 REMOVABLE ADJUSTABLE STRLR HND $95.00NXT-31000 PNEU TIRE WITH AIRLESS INSERT E2211+ E2213 $85.00NXT-31005 PLSTC COATED HANDRIMS 20,22,24 $119.00NXT-31040 PNEUMATIC TIRE E2211 + E2212 $85.00NXT-31045 LOW PROFILE POLYURETHANE TIRE $0.00NXT-31508 FOOT ACTIVATED WHEEL LOCK ASSY $200.00NXT-31530 16" MAG WHEEL $41.00NXT-31533 18" MAG WHEEL $41.00NXT-31538 18" SPOKE WHEEL BLACK NO H/R $0.00NXT-31540 20" PNEUM SPOKE w/ALUM HANDRIM $204.00NXT-31541 22" PNEUM SPOKE w/ALUM HANDRIM $204.00NXT-31542 24" PNEUM SPOKE w/ALUM HANDRIM $204.00NXT-31600 CURB ASSIST ANTI-TIP ASSY ADJ E0971 $150.00NXT-31603 STD ANTI-TIP ASSY FLIP UP ADJ E0971 $150.00NXT-31605 SWING-AWAY ANTI-TIPPERS FT ACT E0971 $175.00NXT-31606 FIXED ANTI-TIP ASSEMBLY E0971 $150.00NXT-31801 WHEEL LOCK EXTENSION HANDLES E0961 $75.00NXT-34111 3" LIGHT UP POLYURETHNE CASTER $65.00NXT-34200 7" X 2" POLY CASTER $200.00NXT-34222 5" X 1.5" POLY PLASTIC MAG CST $87.00NXT-34444 6" X 2" POLY WITH TREAD $97.00NXT-34999 6" X 1.5" POLY PLASTIC MAG $87.00NXT-35050 5" LIGHT UP POLYURETHAN CASTER $101.00NXT-36022 HEEL LOOPS E0951 $45.00NXT-36024 CALF STRAP - WEBBING K0038 $45.00NXT-36029 ANGLE ADJ REM FOOTBOARD ASSY K0040 $190.00NXT-36030 BOLTERON ADJ ANG F/U FTBRD K0040 $190.00NXT-36033 ALU ANG ADJ FLIP-UP FOOTPLATE K0040 $190.00NXT-36040 MAPS - MULTI AXIS POS SYS PAIR $325.00NXT-36402 4.5" HEAVY DUTY EXTENSION $58.00NXT-36403 6.5" HEAVY DUTY EXTENSION $68.00NXT-36410 HIGH MOUNT CLAMPS AND TUBES $102.00NXT-38200 13.5" LOCKING FLIP BACK ARMS E0973 $265.00NXT-38201 10.5" LOCKING FLIP BACK ARMS E0973 $265.00NXT-38203 SINGLE POST HGHT ADJ REM TALL E0973 $285.00NXT-38206 DUAL POST FLIP UP HGHT-ADJ REM E0973 $295.00NXT-38210 10.5"-13.5" FLIP BCK TELES LCK E0973 $275.00NXT-38215 17"-20" FLIP BCK TELESC LCKING E0973 $275.00NXT-38217 SINGLE POST HGHT ADJ REM SHORT E0973 $285.00NXT-39010 FIXED SOLID SEAT PAN - PLST E2231 $150.00

  • Rev. 08.01.2020 25 of 25 Form No. WONXTPL

    Item No. Description HCPCS RETAILNXT-39030-1214 FIXED SLD SEAT PAN - ALU 12X14 E2231 $200.00NXT-39030-1416 FIXED SLD SEAT PAN - ALU 14X16 E2231 $200.00NXT-39030-1618 FIXED SLD SEAT PAN - ALU 16X18 E2231 $200.00NXT-39030-1818 FIXED SLD SEAT PAN - ALU 18x18 E2231 $200.00NXT-39040-1212 FXD, ADJ ALU ST PN 10-12X12 E2231 $290.00NXT-39040-1414 FXD, ADJ ALU ST PN 12-14X14 E2231 $290.00NXT-39040-1616 FXD, ADJ ALU ST PN 14-16X16 E2231 $290.00NXT-39040-1818 FXD, ADJ ALU ST PN 16-18X18 E2231 $290.00NXT-42000 5" X 1.4" POLY ALUMINUM MAG $170.00NXT-43000 4" X 1.4" POLY ALUMINUM MAG $92.00NXT-44000 6 X 1.4" POLY ALUMINUM MAG $170.00NXT-99997 TRANSPORT OPTION - SE $300.00NXT-99998 TRANSPORT OPTION $300.00NXT-EZLITE REM SEAT PAN HDWE KIT 4-PT $207.00SFDI-9HP SELECT HANGER PADS - CUSTOM $92.00